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March 2022
Advanced illness and frailty exclusions allowed for certain HEDIS Star measuresThe National Committee for Quality Assurance allows patients to be excluded from select HEDIS® Star quality measures due to advanced illness and frailty. These exclusions acknowledge that certain services most likely wouldn’t benefit patients who are in declining health. You can 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 Advanced Illness and Frailty Exclusions for HEDIS Star Measures Guide for a description of the advanced illness and frailty exclusion criteria and a list of appropriate HEDIS-approved billing codes. The guide is also posted in the Clinical Quality Corner section of web-DENIS. HEDIS®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance, or NCQA. |
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