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
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
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
The guideline for deceased members (General Guideline 18) is a member-level exclusion. For episode-based measures, if one event does not meet numerator criteria, and the organization chooses to use this optional exclusion, remove all member events/episodes from the measure.
Note: This re-issued FAQ only applies to MY 2022 reporting.
HEDIS MY 2022