FAQ Directory: HEDIS

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12.15.2022 Transitions of Care (TRC) When using the fifth bullet to meet criteria for Medication Reconciliation Post-Discharge, if documentation indicates that the medication reconciliation was performed during a post-op/surgery follow-up visit by the surgeon who performed the surgery or the provider who admitted the member, or if the surgery is for a procedure that is typically performed inpatient, does this count as evidence that the provider was aware of the hospitalization at the time of the visit?

No. Medication reconciliations performed during a post-op/surgery follow-up visit alone do not meet criteria even if the visit was performed by the provider who admitted the member or who performed the surgery, or if the procedure is typically performed inpatient. The intent is that medical record documentation must support awareness of the hospitalization (denominator event) at the time of the medication reconciliation, even if the provider admitted the member or saw the member during the hospitalization, or if the procedure is typically performed inpatient. 

HEDIS MY 2022