Yes; because the Prescreen Status Code criteria requires a code to be in conjunction with another code, the codes must be on the same claim (claims on the same date of service cannot be combined to meet criteria).
HEDIS 2018
FAQ Directory: HEDIS
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10.15.2017 Children With Chronic Conditions When assessing Prescreen Status Code criteria, does the visit code and diagnosis code have to be on the same claim?
10.15.2017 ECDS Must the eMeasure section in the Roadmap be completed for ECDS measures?
Plans work with their NCQA-Certified auditor to complete the most appropriate section of the Roadmap for the data source. The eMeasure section is intended for use by data aggregators and EHR vendors, but may be adapted and modified. Plans should work with auditors or contact NCQA with specific questions about the eMeasure Roadmap or Audit Roadmap Section 5.
HEDIS 2018
10.15.2017 ECDS What is the IP-ECDS Coverage Rate threshold for public reporting of ECDS measure results?
Organizations do not report an IP-ECDS coverage rate; they report a count of members in the initial population covered by ECDS. NCQA does not publicly report these data, which are for internal NCQA use and for benchmarking analysis to help determine the timeline for public reporting.
HEDIS 2018
10.15.2017 ECDS How do EHR vendors submit data and to whom does the submission file go?
Only health plans may submit HEDIS ECDS measure data to NCQA. EHR vendors should work with plans that use their systems to provide data that will be used to calculate HEDIS ECDS measures.
NCQA is currently certifying EHR vendors, to increase the reliability of health IT data used for reporting health care performance. Learn more at:
HEDIS 2018
10.15.2017 Breast Cancer Screening, Colorectal Cancer Screening, Controlling High Blood Pressure, and Osteoporosis Management in Women Who Had a Fracture The Medicare Monthly Membership File includes a run date and a payment date. Which date should be used to determine that a member had an LTI flag during the measurement year?
10.15.2017 ECDS What is ECDS?
Electronic Clinical Data Systems (ECDS) are a network of databases containing plan members’ personal health information and records of their experiences with the health care system. ECDS may also support other care-related activities, directly or indirectly, through various interfaces that include evidence-based decision support, quality management and outcome reporting.
HEDIS 2018
10.15.2017 ECDS How are ECDS measures different from the eMeasures in Meaningful Use?
HEDIS ECDS and eClinical Quality Measures (eCQM) developed for Meaningful Use are specified using the same data standards. eCQMs are specifically designed to use data extracted from an EHR, and HEDIS ECDS measures use multiple data sources to complete the picture of member experience across the care continuum.
HEDIS 2018
10.15.2017 ECDS How are ECDS different from supplemental data?
The ECDS reporting method uses much of the same data classified as supplemental for other HEDIS measures, but ECDS measures adhere to different reporting rules from those in other HEDIS domains. Unlike supplemental data used for HEDIS, data for ECDS reporting are classified by source and are used to report all measure elements (e.g., denominator, exclusions, numerator).
HEDIS 2018
10.15.2017 ECDS How do vendors get the ECDS technical specifications for the submission file format?
HEDIS ECDS technical specifications are available in the NCQA store in PDF format: http://store.ncqa.org/index.php/catalog/product/view/id/2822/s/hedis-2018-volume-2-measures-for-electronic-clinical-data-systems/. They are also available in HEDIS 2018 Technical Specifications for Health Plans, which can be purchased at the NCQA store.
Complete digital measure packages for HEDIS ECDS measures will be available for download at a future date.
HEDIS 2018
10.15.2017 ECDS Will ECDS measures be used for Health Plan Accreditation or ratings?
ECDS measures are currently not approved for public reporting by NCQA, and are not eligible for use in HPA or health plan ratings. All measures must be approved for public reporting by the Committee on Performance Measurement (CPM) before they can be considered for inclusion in an NCQA program.
HEDIS 2018
10.15.2017 ECDS Are we required to collect and report the source vendor for the data e.g., by vendor)and source system of record (e.g., EHR, HIE, case management, claims) when reporting ECDS categories?
Details about the data vendor or source EHR system are not required for ECDS reporting, but should be documented in the HEDIS Roadmap when identifying data sources for an NCQA-Certified auditor. Use of data from NCQA eCQM-Certified vendors will ensure that measure data extracted from these systems are considered standard.
ECDS data should be categorized by one of the four source record categories stated in ECDS General Guideline 2: Data Collection Methods (EHR, HIE/clinical registry, case management registry, administrative claims).
HEDIS 2018
10.15.2017 ECDS If case management data are used only by behavioral health-care providers (not by primary care providers), may these data be an ECDS data source?
Case management data may be used for measures using the ECDS reporting method if the information collected by case managers is available on request to all providers treating the same member in another setting.Â
Data are not required to be accessed to qualify for ECDS reporting, but must be available on request to providers providing care to the member.
HEDIS 2018