FAQ Directory: HEDIS

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5.16.2022 MY 2022 Technical Update – COL-E Measure In the updated version of the COL-E measure that was re-released in the MY 2022 Technical Update, the “Total” data element listed in the age column is not highlighted in Table COL-E-A-3: Data Elements for Colorectal Cancer Screening. Should this cell be highlighted?

Yes. The cell should be highlighted to indicate that it is calculated by IDSS.

HEDIS MY 2022

4.15.2022 Data Aggregator Validation (DAV) Data for ECDS Reporting Can validated DAV data streams be used for ECDS reporting? If yes, how should they be categorized (which SSoR)?

Yes. If validated DAV streams are used, they should be categorized as HIE/clinical registry data sources.

HEDIS MY 2021

4.15.2022 Data Aggregator Validation (DAV) Data for ECDS Reporting Can validated DAV data streams be used for ECDS reporting? If yes, how should they be categorized (which SSoR)?

Yes. If validated DAV streams are used, they should be categorized as HIE/clinical registry data sources.

HEDIS MY 2022

4.15.2022 Initiation and Engagement of Substance Use Disorder Treatment (IET) Should denominator episodes be deduplicated to one per day? For example, if a member has two outpatient visits with an SUD diagnosis on the same date of service (with different providers), is it one denominator episode or two?

Deduplicate denominator episodes to one per day. Two eligible SUD encounters on the same date of service count as one denominator episode.  

HEDIS MY 2022

2.15.2022 COVID-19 Is HEDIS changing data collection strategies for HEDIS MY 2021 due to COVID?

NCQA continues to monitor the impact of COVID on communities and at this time has no plans to modify data collection methods and reporting deadlines.

HEDIS MY 2021

2.15.2022 Cervical Cancer Screening (CCS) For cervical cancer screening, should we exclude transgender women (male to female, never had a cervix)?

Administrative data, codes in the Absence of Cervix Diagnosis Value Set (e.g., ICD-10-CM Diagnosis code Q51.5 [agenesis and aplasia of cervix]) may be used to exclude transgender members from the measure. If the medical record documents that the member was born male (e.g., transgender male to female), this is evidence that the member does not have a cervix, meets optional exclusion criteria and may be removed from the measure. Medical record documentation of cervical agenesis or clinical synonyms (e.g., evidence a patient was born without a cervix) may also be used to exclude these members. These members should remain in the measure if the organization is unable to find the appropriate documentation.

HEDIS MY 2021

2.15.2022 Guidelines for Calculations and Sampling: Hybrid Measures When reducing sample sizes for measures with stratifications, which are used: the total rates or the stratified rates?

For measures with stratifications, use the total rate when reducing sample sizes. For measures with multiple indicators and stratifications, use the lowest total rate across indicators when reducing sample sizes.

HEDIS MY 2021

1.14.2022 Continuity of Care Documents Can Continuity of Care Documents (CCDs)/style sheets generated from CCDs be used for hybrid abstraction?

No. CCDs are not considered a legal health record and may not be used for hybrid abstraction.

HEDIS MY 2021

1.14.2022 Continuity of Care Documents Can Continuity of Care Documents (CCDs)/style sheets generated from CCDs be used for hybrid abstraction?

No. CCDs are not considered a legal health record and may not be used for hybrid abstraction. 

HEDIS MY 2022

12.15.2021 Updated FAQs Were there previously posted FAQs that have been updated?

Yes. There were two previously posted FAQs that have been recently updated. One FAQ was posted in September and the second was posted in November. Both FAQs were updated and can be found on the FAQ page with the date of 12.3.2021.

HEDIS MY 2022

12.15.2021 General Guideline 32: Obtaining Information for the Systematic Sample Measures In which data element should exclusions be reported when exclusion information is found through a data refresh?

For HEDIS MY 2021 reporting, reporting exclusions in different categories found through a data refresh is flexible; for example, number of original sample records excluded because of valid data errors, number of administrative data records excluded and so on. Record counts must be able to be reconciled between the MRSS, the number of exclusions, records added from the oversample and the denominator.

HEDIS MY 2021

12.15.2021 Updated FAQs Were there previously posted FAQs that have been updated?

Yes. There were two previously posted FAQs that have been recently updated. One FAQ was posted in September and the second was posted in November. Both FAQs were updated and can be found on the FAQ page with the date of 12.3.2021.

HEDIS MY 2021