FAQ Directory

Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can  ask a question through My NCQA.

Filter Results
  • Save

    Save your favorite pages and receive notifications whenever they’re updated.

    You will be prompted to log in to your NCQA account.

  • Email

    Share this page with a friend or colleague by Email.

    We do not share your information with third parties.

  • Print

    Print this page.

You are viewing a single FAQ from your previous search. Clear Search

expand all

3.13.2015 Proportion of Days Covered by Medications (PDC) An answer to an FAQ posted on 2/17/15 states, “Exclude members whose ESRD diagnosis is noted any time during the measurement year.”
The MARx System output, which contains the RxHCC codes, does not release the entire 2014 dates of service until after the IHA reporting deadline. Does the FAQ apply to both the RxHCC and ICD-9-CM code?

The intent is to use the most current information for the ESRD exclusion. If ICD-9-CM is used, then any code from the value set during the measurement year excludes the member from the denominator. If the MARx System output is used, then the most recent version applies. Although the time frames are not consistent between ICD-9-CM and RxHCC, it is the most current information to identify patients with ESRD. ICD-9-CM is preferred, but if it is not available, the most current MARx System output can be used.

ALL 2014