Back to top
Top

Childhood Immunization Status

Measure Information 2023 Performance Period
CMS eCQM ID CMS117v11
NQF Number Not Applicable
MIPS Quality ID 240
Description

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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

Initial Population

Children who turn 2 years of age during the measurement period and have a visit during the measurement period

Numerator

Diphtheria, tetanus, and pertussis (DTaP) vaccination

Children with any of the following on or before the child’s second birthday meet criteria:

• At least four DTaP vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the diphtheria, tetanus or pertussis vaccine.

• Encephalitis due to the diphtheria, tetanus or pertussis vaccine.

Poliovirus vaccination (IPV)

At least three IPV vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Measles, mumps, and rubella vaccination (MMR)

Children with either of the following meet criteria:

• At least one MMR vaccination on or between the child’s first and second birthdays.

• All of the following anytime on or before the child’s second birthday (on the same or different date of service):

o History of measles

o History of mumps

o History of rubella

Haemophilus influenzae type b vaccination (HiB)

Children with either of the following meet criteria on or before the child’s second birthday:

• At least three HiB vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the HiB vaccine.

Hepatitis B

Children with any of the following on or before the child’s second birthday meet criteria:

• At least three hepatitis B vaccinations, with different dates of service.

o One of the three vaccinations can be a newborn hepatitis B vaccination during the eight-day period that begins on the date of birth and ends seven days after the date of birth. For example, if the member’s date of birth is December 1, the newborn hepatitis B vaccination must be on or between December 1 and December 8.

• Anaphylaxis due to the hepatitis B vaccine.

• History of hepatitis B illness.

Varicella vaccination (VZV)

Children with either of the following meet criteria:

• At least one VZV vaccination, with a date of service on or between the child’s first and second birthdays.

• History of varicella zoster (e.g., chicken pox) illness on or before the child’s second birthday.

Pneumococcal Conjugate

At least four pneumococcal conjugate vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Hepatitis A

Children with either of the following meet criteria:

• At least one hepatitis A vaccination, with a date of service on or between the child’s first and second birthdays.

• History of hepatitis A illness on or before the child’s second birthday.

Rotavirus

Children with any of the following meet criteria:

• At least two doses of the two-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• At least three doses of the three-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• At least one dose of the two-dose rotavirus vaccine and at least two doses of the three-dose rotavirus vaccine, all on different dates of service, on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the rotavirus vaccine on or before the child’s second birthday.

Influenza

At least two influenza vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 6 months (180 days) after birth.

• One of the two vaccinations can be an LAIV vaccination administered on the child’s second birthday. Do not count an LAIV vaccination administered before the child’s second birthday.

Numerator Exclusions

Not Applicable

Denominator

Equals Initial Population

Denominator Exclusions

Exclude children with any of the following on or before the child’s second birthday:

• Severe combined immunodeficiency

• Immunodeficiency

• HIV

• Lymphoreticular cancer, multiple myeloma or leukemia

• Intussusception

Exclude children who are in hospice care for any part of the measurement period.

Denominator Exceptions

None

Steward National Committee for Quality Assurance
Measure Scoring Proportion measure
Measure Type Process measure
Improvement Notation

Higher score indicates better quality

Guidance

The measure allows a grace period by measuring compliance with these recommendations between birth and age two.

This eCQM is a patient-based measure.

 

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Telehealth Eligible Yes
Next Version
Previous Version

Compare eCQM Versions

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Filter Measure By
Measure Information 2021 Performance Period 2022 Performance Period 2023 Performance Period 2024 Performance Period
Title Childhood Immunization Status Childhood Immunization Status Childhood Immunization Status Childhood Immunization Status
CMS eCQM ID CMS117v9 CMS117v10 CMS117v11 CMS117v12
NQF Number Not Applicable Not Applicable Not Applicable Not Applicable
Description

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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

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 or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

Initial Population

Children who turn 2 years of age during the measurement period and who have a visit during the measurement period

Children who turn 2 years of age during the measurement period and who have a visit during the measurement period

Children who turn 2 years of age during the measurement period and have a visit during the measurement period

Children who turn 2 years of age during the measurement period and have a visit during the measurement period

Denominator

Equals Initial Population

Equals Initial Population

Equals Initial Population

Equals Initial Population

Denominator Exclusions Exclude patients whose hospice care overlaps the measurement period Exclude patients who are in hospice care for any part of the measurement period. Exclude children with any of the following on or before the child’s second birthday: • Severe combined immunodeficiency • Immunodeficiency • HIV • Lymphoreticular cancer, multiple myeloma or leukemia • Intussusception Exclude children who are in hospice care for any part of the measurement period. Exclude children with any of the following on or before the child’s second birthday: - Severe combined immunodeficiency - Immunodeficiency - HIV - Lymphoreticular cancer, multiple myeloma or leukemia - Intussusception Exclude children who are in hospice care for any part of the measurement period.
Numerator

Children who have evidence showing they received recommended vaccines, had documented history of the illness, had a seropositive test result, or had an allergic reaction to the vaccine by their second birthday

Children who have evidence showing they received recommended vaccines, had documented history of the illness, had a seropositive test result, or had an allergic reaction to the vaccine by their second birthday

Diphtheria, tetanus, and pertussis (DTaP) vaccination

Children with any of the following on or before the child’s second birthday meet criteria:

• At least four DTaP vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the diphtheria, tetanus or pertussis vaccine.

• Encephalitis due to the diphtheria, tetanus or pertussis vaccine.

Poliovirus vaccination (IPV)

At least three IPV vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Measles, mumps, and rubella vaccination (MMR)

Children with either of the following meet criteria:

• At least one MMR vaccination on or between the child’s first and second birthdays.

• All of the following anytime on or before the child’s second birthday (on the same or different date of service):

o History of measles

o History of mumps

o History of rubella

Haemophilus influenzae type b vaccination (HiB)

Children with either of the following meet criteria on or before the child’s second birthday:

• At least three HiB vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the HiB vaccine.

Hepatitis B

Children with any of the following on or before the child’s second birthday meet criteria:

• At least three hepatitis B vaccinations, with different dates of service.

o One of the three vaccinations can be a newborn hepatitis B vaccination during the eight-day period that begins on the date of birth and ends seven days after the date of birth. For example, if the member’s date of birth is December 1, the newborn hepatitis B vaccination must be on or between December 1 and December 8.

• Anaphylaxis due to the hepatitis B vaccine.

• History of hepatitis B illness.

Varicella vaccination (VZV)

Children with either of the following meet criteria:

• At least one VZV vaccination, with a date of service on or between the child’s first and second birthdays.

• History of varicella zoster (e.g., chicken pox) illness on or before the child’s second birthday.

Pneumococcal Conjugate

At least four pneumococcal conjugate vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

Hepatitis A

Children with either of the following meet criteria:

• At least one hepatitis A vaccination, with a date of service on or between the child’s first and second birthdays.

• History of hepatitis A illness on or before the child’s second birthday.

Rotavirus

Children with any of the following meet criteria:

• At least two doses of the two-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• At least three doses of the three-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• At least one dose of the two-dose rotavirus vaccine and at least two doses of the three-dose rotavirus vaccine, all on different dates of service, on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

• Anaphylaxis due to the rotavirus vaccine on or before the child’s second birthday.

Influenza

At least two influenza vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 6 months (180 days) after birth.

• One of the two vaccinations can be an LAIV vaccination administered on the child’s second birthday. Do not count an LAIV vaccination administered before the child’s second birthday.

DTaP

Children with any of the following on or before the child’s second birthday meet criteria:

- At least four DTaP vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

- Anaphylaxis due to the diphtheria, tetanus or pertussis vaccine.

- Encephalitis due to the diphtheria, tetanus or pertussis vaccine.

IPV

Children with either of the following on or before the child’s second birthday meet criteria:

- At least three IPV vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

- Anaphylaxis due to the IPV vaccine.

MMR

Children with any of the following meet criteria:

- At least one MMR vaccination on or between the child’s first and second birthdays.

- Anaphylaxis due to the MMR vaccine on or before the child’s second birthday.

- All of the following anytime on or before the child’s second birthday (on the same or different date of service):

- History of measles.

- History of mumps.

- History of rubella.

HiB

Children with either of the following meet criteria on or before the child’s second birthday:

- At least three HiB vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.

- Anaphylaxis due to the HiB vaccine.

Hep B

Children with any of the following on or before the child’s second birthday meet criteria:

- At least three hepatitis B vaccinations, with different dates of service.

- One of the three vaccinations can be a newborn hepatitis B vaccination during the eight-day period that begins on the date of birth and ends seven days after the date of birth. For example, if the member’s date of birth is December 1, the newborn hepatitis B vaccination must be on or between December 1 and December 8.

- Anaphylaxis due to the hepatitis B vaccine.

- History of hepatitis B illness.

VZV

Children with any of the following meet criteria:

- At least one VZV vaccination, with a date of service on or between the child’s first and second birthdays.

- Anaphylaxis due to the VZV vaccine on or before the child’s second birthday.

- History of varicella zoster (e.g., chicken pox) illness on or before the child’s second birthday.

PCV

Children with either of the following on or before the child’s second birthday meet criteria:

- At least four pneumococcal conjugate vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

- Anaphylaxis due to the pneumococcal vaccine.

Hep A

Children with any of the following meet criteria:

- At least one hepatitis A vaccination, with a date of service on or between the child’s first and second birthdays.

- Anaphylaxis due to the hepatitis A vaccine on or before the child’s second birthday.

- History of hepatitis A illness on or before the child’s second birthday.

RV

Children with any of the following meet criteria:

- At least two doses of the two-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

- At least three doses of the three-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

- At least one dose of the two-dose rotavirus vaccine and at least two doses of the three-dose rotavirus vaccine, all on different dates of service, on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.

- Anaphylaxis due to the rotavirus vaccine on or before the child’s second birthday.

Flu

Children with either of the following on or before their second birthday meet criteria:

- At least two influenza vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 6 months (180 days) after birth.

- One of the two vaccinations can be a Live Attenuated Influenza Vaccine (LAIV) vaccination administered on the child’s second birthday. Do not count a LAIV vaccination administered before the child’s second birthday.

- Anaphylaxis due to the influenza vaccine.

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Denominator Exceptions

None

None

None

None

Measure Steward National Committee for Quality Assurance National Committee for Quality Assurance National Committee for Quality Assurance National Committee for Quality Assurance
Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process measure Process measure Process measure Process measure
Improvement Notation

Higher score equals better quality

Higher score equals better quality

Higher score indicates better quality

Higher score indicates better quality

Guidance

For the MMR, hepatitis B, VZV and hepatitis A vaccines, numerator inclusion criteria include: evidence of receipt of the recommended vaccine; documented history of the illness; or, a seropositive test result for the antigen. For the DTaP, IPV, Hib, pneumococcal, rotavirus, and influenza vaccines, numerator inclusion criteria include only evidence of receipt of the recommended vaccine.

Patients may be included in the numerator for a particular antigen if they had an anaphylactic reaction to the vaccine. Patients may be included in the numerator for the DTaP vaccine if they have encephalopathy. Patients may be included in the numerator for the IPV vaccine if they have had an anaphylactic reaction to streptomycin, polymyxin B, or neomycin. Patients may be included in the numerator for the influenza, MMR, or varicella vaccines if they have cancer of lymphoreticular or histiocytic tissue, multiple myeloma, leukemia, have had an anaphylactic reaction to neomycin, have immunodeficiency, or have HIV. Patients may be included in the numerator for the hepatitis B vaccine if they have had an anaphylactic reaction to common baker's yeast.

The measure allows a grace period by measuring compliance with these recommendations between birth and age two.

This eCQM is a patient-based measure.

 

This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.

Numerator criteria includes evidence of receipt of the recommended vaccine or the following:

-- DTaP:

Adverse reaction to the DTaP or Td vaccine; or encephalopathy due to DTaP or Td vaccination

-- Polio (IPV) vaccine:

Adverse reaction to the IPV vaccine, streptomycin, polymyxin B, or neomycin

-- MMR Vaccination:

Immunodeficiency, HIV, lymphoreticular cancer, multiple myeloma, or leukemia; adverse reaction to neomycin; history of measles, mumps, or rubella; or a seropositive result for the antigens

-- Hib:

Adverse reaction to the Hib vaccine

-- Hepatitis B:

Seropositive result for the antigen, adverse reaction to the hepatitis B vaccine, adverse reaction to common baker’s yeast, or a history of hepatitis B illness

-- Chicken pox (varicella zoster):

Seropositive result for the antigen; immunodeficiency, HIV, lymphoreticular cancer, multiple myeloma, or leukemia; adverse reaction to neomycin; or a history of varicella zoster

-- Pneumococcal:

Adverse reaction to the pneumococcal vaccine

-- Hepatitis A:

Seropositive result for the antigen, adverse reaction to the hepatitis A vaccine, or a history of hepatitis A illness

-- Rotavirus:

Adverse reaction to the rotavirus vaccine, severe combined immunodeficiency, or a history of intussusception

-- Influenza:

Adverse reaction to the influenza vaccine; immunodeficiency, HIV, lymphoreticular cancer, multiple myeloma, or leukemia; or adverse reaction to neomycin

The measure allows a grace period by measuring compliance with these recommendations between birth and age two.

This eCQM is a patient-based measure.

 

This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.

The measure allows a grace period by measuring compliance with these recommendations between birth and age two.

This eCQM is a patient-based measure.

 

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

The measure allows a grace period by measuring compliance with these recommendations between birth and age two.

This eCQM is a patient-based measure.

 

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

MIPS Quality ID 240 240 240 240
Telehealth Eligible Yes Yes Yes Yes
Next Version CMS117v10 CMS117v11 CMS117v12 No Version Available
Previous Version No Version Available

Release Notes

Header

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Removed language related to adverse reactions from the guidance to align with the measure intent.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.

    Measure Section: Guidance

    Source of Change: Standards/Technical Update

  • Removed seropositive test results from the narrative because conducting antibody testing to determine immunity from a disease in lieu of vaccination is not specifically recommended by the CDC.

    Measure Section: Numerator

    Source of Change: Measure Lead

  • Relocated information regarding vaccination guidelines from the clinical recommendation statement to the numerator to improve clarity.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Relocated the numerator inclusion criteria from the guidance field to the denominator exclusions for children with severe combined immunodeficiency, immunodeficiency, HIV, lymphoreticular cancer, multiple myeloma or leukemia, and intussusception before their second birthday.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated grammar and punctuation to improve readability.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Updated the logic to replace the value set, 'Encephalopathy due to Childhood Vaccination' with 'Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine' to align with the measure intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Revised the logic timing requirement for the Hepatitis A, MMR, and VZV vaccination to align with the intent of the measure and CDC recommendations.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Removed the Anaphylactic Reaction to Common Baker's Yeast value set from the logic to align with the measure intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Removed seropositive test results from the numerator logic because conducting antibody testing to determine immunity from a disease in lieu of vaccination is not specifically recommended by the CDC.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Added QDM datatypes 'Encounter, Performed' and 'Assessment, Performed' and associated logic to the Hospice.'Has Hospice Services' definition to provide additional approaches for identifying patients receiving hospice services.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the logic to add the 'NormalizeInterval' function to additional QDM datatypes to decrease implementation burden due to variable use of timing attributes.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the version number of the Hospice Library to v4.0.000.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Relocated the numerator inclusion criteria logic to the denominator exclusions logic for children with severe combined immunodeficiency, immunodeficiency, HIV, lymphoreticular cancer, multiple myeloma or leukemia, and intussusception before their second birthday.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the logic to align with the numerator requirement for the Hepatitis B vaccine criteria.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the timing precision in the definitions from datetime to date by adding 'day of', 'date from', and/or function 'ToDateInterval' to align with the measure intent.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Replaced the Global.CalendarAgeInYearsAt function with the native CQL function AgeInYearsAt to take advantage of existing CQL features and increase human readability. As a result of this change, the LOINC code 21112-8 is no longer required and has been removed from the Terminology section of the human readable specification.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Updated the logic to remove adverse reaction criteria related to vaccines to align with the intent of the measure.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Value set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Inactivated Polio Vaccine (IPV) (2.16.840.1.113883.3.464.1003.196.12.1219): Added 1 CVX code (146) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Severe Combined Immunodeficiency (2.16.840.1.113883.3.464.1003.120.12.1007): Added 8 SNOMED CT codes (763623001, 765188009, 783617001, 789777007, 765145001, 771517009, 782751003, 987840791000119102) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Inactivated Polio Vaccine (IPV) Administered (2.16.840.1.113883.3.464.1003.110.12.1045): Added 1 SNOMED CT code (16290681000119103) based on review by technical experts, SMEs, and/or public feedback. Added 1 CPT code (90697) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Influenza Vaccine (2.16.840.1.113883.3.464.1003.196.12.1218): Added 2 CVX codes (171, 186) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 CVX code (135) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Influenza Vaccine Administered (2.16.840.1.113883.3.464.1003.110.12.1044): Added 2 CPT codes (90674, 90756) based on review by technical experts, SMEs, and/or public feedback. Added 1 SNOMED CT code (786847005) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Malignant Neoplasm of Lymphatic and Hematopoietic Tissue (2.16.840.1.113883.3.464.1003.108.12.1009): Added 28 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback. Deleted 16 SNOMED CT codes based on validity of code during timing of look back period. Added 1 ICD-10-CM code (C84.7A) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 ICD-10-CM code (C96.2) based on validity of code during timing of look back period.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Measles (2.16.840.1.113883.3.464.1003.110.12.1053): Added 2 SNOMED CT codes (417145006, 424306000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Pneumococcal Conjugate Vaccine (2.16.840.1.113883.3.464.1003.196.12.1221): Added 1 CVX code (109) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Varicella Zoster (2.16.840.1.113883.3.464.1003.110.12.1039): Added 8 SNOMED CT codes (1087131000119102, 15678841000119100, 15680281000119103, 15991751000119109, 15992351000119104, 16000751000119105, 16000791000119100, 16000831000119106) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (292927007) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hib Vaccine (4 dose schedule) Administered (2.16.840.1.113883.3.464.1003.110.12.1086): Deleted 6 SNOMED CT codes (127787002, 170343007, 170344001, 170345000, 170346004, 312869001) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 CPT code (90748) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code LOINC code (21112-8) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (292925004) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (292992006) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (293116002) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (293117006) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (293126009) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code SNOMED CT code (420113004) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hib Vaccine (4 dose schedule) (2.16.840.1.113883.3.464.1003.110.12.1085): Added 1 CVX code (146) based on review by technical experts, SMEs, and/or public feedback. Deleted 2 CVX codes (50, 51) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Anaphylactic Reaction to DTaP Vaccine (2.16.840.1.113883.3.464.1003.199.12.1031): Deleted 2 SNOMED CT codes (219084006, 293108006) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hib Vaccine (3 dose schedule) Administered (2.16.840.1.113883.3.464.1003.110.12.1084): Added 2 CPT codes (90697, 90748) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Mumps Antibody Test (IgG Antibody presence) (2.16.840.1.113883.3.464.1003.198.12.1062) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hepatitis B Vaccine Administered (2.16.840.1.113883.3.464.1003.110.12.1042): Added 1 CPT code (90697) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Hospice Care Ambulatory (2.16.840.1.113762.1.4.1108.15) with value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Encephalopathy due to Childhood Vaccination (2.16.840.1.113883.3.464.1003.114.12.1007) with value set Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine (2.16.840.1.113883.3.464.1003.1164) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Hospice Encounter (2.16.840.1.113883.3.464.1003.1003) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Anaphylactic Reaction to Common Baker's Yeast (2.16.840.1.113883.3.464.1003.199.12.1032) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Anti Hepatitis A IgG Antigen Test (2.16.840.1.113883.3.464.1003.198.12.1033) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Anti Hepatitis B Virus Surface Ab (2.16.840.1.113883.3.464.1003.198.12.1073) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Measles Antibody Test (IgG Antibody Titer) (2.16.840.1.113883.3.464.1003.198.12.1059) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Measles Antibody Test (IgG Antibody presence) (2.16.840.1.113883.3.464.1003.198.12.1060) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Mumps Antibody Test (IgG Antibody Titer) (2.16.840.1.113883.3.464.1003.198.12.1061) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hib Vaccine (3 dose schedule) (2.16.840.1.113883.3.464.1003.110.12.1083): Added 2 CVX codes (17, 51) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code LOINC code (45755-6) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Rubella Antibody Test (IgG Antibody Titer) (2.16.840.1.113883.3.464.1003.198.12.1063) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Rubella Antibody Test (IgG Antibody presence) (2.16.840.1.113883.3.464.1003.198.12.1064) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Varicella Zoster Antibody Test (IgG Antibody Presence) (2.16.840.1.113883.3.464.1003.198.12.1067) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Varicella Zoster Antibody Test (IgG Antibody Titer) (2.16.840.1.113883.3.464.1003.198.12.1066) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set DTaP Vaccine (2.16.840.1.113883.3.464.1003.196.12.1214): Added 1 CVX code (146) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set DTaP Vaccine Administered (2.16.840.1.113883.3.464.1003.110.12.1022): Added 1 CPT code (90697) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Disorders of the Immune System (2.16.840.1.113883.3.464.1003.120.12.1001): Added 4 SNOMED CT codes (724361001, 1144907001, 1144908006, 1144963000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set HIV (2.16.840.1.113883.3.464.1003.120.12.1003): Added 13 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback. Added 6 ICD-10-CM codes (O98.711, O98.712, O98.713, O98.719, O98.72, O98.73) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hepatitis B Vaccine (2.16.840.1.113883.3.464.1003.196.12.1216): Added 1 CVX code (146) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Positive Finding (2.16.840.1.113883.3.464.1003.121.12.1016) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code SNOMED CT code (373066001) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: May 02, 2023