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NCQA Updates to Heart-Stroke Recognition Program

NCQA is making minor changes to its Heart-Stroke Recognition Program (HSRP) effective February 5, 2018. Changes will provide updated codes to the NDC list, value set and data dictionary for the Statin Therapy for Patients With Cardiovascular Disease (SPC) HEDIS measure.

Update to NDC List Table Names

As HEDIS® measures evolve, more information may be necessary for measurement. NCQA will provide NDC lists for practices to use when submitting measurement data. Links to NDC lists will be available in the “Resources” section of the data collection tool.

The NDC table names for SPC have changed but the content remains the same. Below are the new table names to identify NDC codes for the SPC measure.

  • Table SPC-A: Estrogen Agonists Medications List
  • Table SPC-B: High and Moderate-Intensity Statin Medications List

Updated Value Set and Data Dictionary Codes for HSRP

The list of eligible ICD-9 and ICD-10 codes to identify patients with ischemic vascular disease (IVD) has changed. The list of codes and the value set table will be updated to ensure that practices have the most current list to identify patients for the sample.

ICD Codes Added to the IVD Value Set

 ICD-10 CM Codes
 I63.213, I63.233, I63.513, I63.523, I63.533, I63.543, T82.855A, T82.855D, T82.855S, T82.856A, T82.856D, T82.856S
 Description Prescription
 High-intensity statin therapy  Atorvastatin 40–80 mg
 Amlodipine-atorvastatin 40–80 mg
 Ezetimibe-atorvastatin 40–80 mg 
 Rosuvastatin 20–40 mg
 Simvastatin 80 mg
 Ezetimibe-simvastatin 80 mg
 Moderate-intensity statin therapy  Atorvastatin 10–20 mg
 Amlodipine-atorvastatin 10–20 mg
 Ezetimibe-atorvastatin 10–20 mg
 Rosuvastatin 5–10 mg
 Simvastatin 20–40 mg
 Ezetimibe-simvastatin 20–40 mg
 Niacin-simvastatin 20–40 mg  Sitagliptin-simvastatin 20–40 mg
 Pravastatin 40–80 mg
 Lovastatin 40 mg
 Niacin-lovastatin 40 mg
 Fluvastatin XL 80 mg
 Fluvastatin 40 mg bid
 Pitavastatin 2–4 mg
 Low-intensity statin therapy  Simvastatin 10 mg 
 Ezetimibe-simvastatin 10 mg
 Sitagliptin-simvastatin 10 mg
 Pravastatin 10–20 mg  Lovastatin 20 mg 
 Niacin-lovastatin 20 mg 
 Fluvastatin 20–40 mg 
 Pitavastatin 1 mg