Line of business: BlueAlliance (Commercial)
Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB), one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday.
Children who received all the following (each row) on or before their second birthday meet criteria.
Note: Compliance can be met with any of the listed criteria for each vaccine (i.e. patient received the vaccine/antigen doses or has a history of the illness or history of the vaccine causing anaphylaxis or encephalitis).
Vaccine | Doses | Combo vaccine or antigen | History of illness | Anaphylaxis r/t vaccine | Encephalitis r/t vaccine | |
DTaP | Diptheria, tetanus, acellar pertussis | 4 | X | X | X | |
IPV | Polio | 3 | X | X | ||
MMR | Measles, mumps, rubella | 1 | X | X | X | |
HiB | Hemophilus influenza B | 3 | X | X | ||
HepB | Hepatitis B | 3 | X | X | X | |
VZV | Varicella zoster (Chicken Pox) | 1 | X | X | X | |
PCV | Pneumococcal conjugate | 4 | X | X | ||
HepA | Hepatitis A | 1 | X | X | X | |
RV | Rotavirus | 2-3 | X | X | ||
Flu | Influenza | 2 | X | X |
The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.
Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.
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