FAQ Directory: HEDIS

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11.16.2015 Administrative-only Measures For administrative-only measures such as Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART), may organizations abstract medication information from the medical record to identify numerator hits?

For administrative-only measures, information abstracted from the medical record is considered nonstandard supplemental data and is subject to all requirements described in General Guideline 34. The supplemental data must include all data elements required by the measure specification. For pharmacy data, this means that all data elements from the NDC lists must be present: the generic name, strength/dose, route and date when the medication was dispensed to the member. Generic documentation in the medical record (e.g., that a patient “was prescribed” or “is taking” a medication) that does not include drug name, strength/dose and dispense date does not meet criteria.

HEDIS 2016