HEDIS and Quality Measure Improvement

HEDIS and Relative Resource Use (RRU)

When linked with HEDIS quality data, RRU measures help members, plans, employers, benefit managers and other interested groups, make informed choices about health care services. Members get a more detailed look at the value of services they pay for, while plans can see how effectively they use resources, compared to other plans, when delivering health care. Learn More

HEDIS and ICD-10 Information

ICD-9-CM is an official classification system that practitioners in the United States use to code diagnoses and procedures on health care claim forms. Organizations use ICD-9-CM codes from claim and encounter data to identify diagnoses and procedures for HEDIS reporting.

To accommodate the switch to ICD-10 (implementation date to be determined), NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure. Beginning in 2011, NCQA began converting affected measures each year. With support from the HEDIS Expert Coding Panel, NCQA staff identified ICD-10 codes for each HEDIS coding table that contained ICD-9-CM codes. NCQA posted the proposed ICD-10 codes to its Web site for organization review and comment (July 1–December 16, 2013).

After the implementation date is set, NCQA will add ICD-10 codes to the HEDIS measure specifications to correspond with the impacted measurement year. ICD-9 codes will be phased out using NCQA’s policy for removing obsolete codes: codes are removed from a measure when the look-back period for the measure, plus one additional year, is exhausted. NCQA posts FAQs about ICD-10 and HEDIS on the FAQ page of the NCQA Web site at: http://faq.ncqa.org.


HEDIS and ICD-10 Information

ICD-9-CM is an official classification system that practitioners in the United States use to code diagnoses and procedures on health care claim forms. Organizations use ICD-9-CM codes from claim and encounter data to identify diagnoses and procedures for HEDIS reporting.

To accommodate the switch to ICD-10 (implementation date to be determined), NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure. Beginning in 2011, NCQA began converting affected measures each year. With support from the HEDIS Expert Coding Panel, NCQA staff identified ICD-10 codes for each HEDIS coding table that contained ICD-9-CM codes. NCQA posted the proposed ICD-10 codes to its Web site for organization review and comment (July 1–December 16, 2013).

After the implementation date is set, NCQA will add ICD-10 codes to the HEDIS measure specifications to correspond with the impacted measurement year. ICD-9 codes will be phased out using NCQA’s policy for removing obsolete codes: codes are removed from a measure when the look-back period for the measure, plus one additional year, is exhausted. NCQA posts FAQs about ICD-10 and HEDIS on the FAQ page of the NCQA Web site at: http://faq.ncqa.org.

- See more at: http://www.ncqa.org/HEDISQualityMeasurement/HEDISandQualityMeasureImprovement/HEDISandICD10.aspx#sthash.dVdSL58X.dpuf

HEDIS and ICD-10 Information

ICD-9-CM is an official classification system that practitioners in the United States use to code diagnoses and procedures on health care claim forms. Organizations use ICD-9-CM codes from claim and encounter data to identify diagnoses and procedures for HEDIS reporting.

To accommodate the switch to ICD-10 (implementation date to be determined), NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure. Beginning in 2011, NCQA began converting affected measures each year. With support from the HEDIS Expert Coding Panel, NCQA staff identified ICD-10 codes for each HEDIS coding table that contained ICD-9-CM codes. NCQA posted the proposed ICD-10 codes to its Web site for organization review and comment (July 1–December 16, 2013).

After the implementation date is set, NCQA will add ICD-10 codes to the HEDIS measure specifications to correspond with the impacted measurement year. ICD-9 codes will be phased out using NCQA’s policy for removing obsolete codes: codes are removed from a measure when the look-back period for the measure, plus one additional year, is exhausted. NCQA posts FAQs about ICD-10 and HEDIS on the FAQ page of the NCQA Web site at: http://faq.ncqa.org.

- See more at: http://www.ncqa.org/HEDISQualityMeasurement/HEDISandQualityMeasureImprovement/HEDISandICD10.aspx#sthash.dVdSL58X.dpuf

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