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April 2021
Advanced illness, frailty exclusions allowed for select HEDIS measuresAction item Check out the HEDIS® Advanced Illness and Frailty Exclusions Guide that we link to in this article. The National Committee for Quality Assurance allows patients to be excluded from select HEDIS quality measures due to advanced illness and frailty. The NCQA acknowledges** that measured services most likely would not benefit patients who are in declining health. Health care providers may submit claims with advanced illness and frailty codes to exclude patients from select measures. Using these codes also reduces medical record requests for HEDIS data collection purposes. Read the HEDIS® Advanced Illness and Frailty Exclusions Guide for a description of the advanced illness and frailty exclusion criteria and a list with some of the appropriate HEDIS‑approved billing codes. HEDIS®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance. **Blue Cross Blue Shield of Michigan doesn’t own or control this website. |
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