MEASURES
This quality improvement project will use the 2019 HEDIS Prenatal Immunization Measures. Download the measures here.
NUMERATORS:
- The total number of non-excluded deliveries where the patient received an influenza vaccine during the preceding 9 months; and
- The total number of non-excluded deliveries where the patient received at least one Tdap vaccine during the pregnancy (including on the delivery date); and
- The total number of non-excluded deliveries where the patient received both an influenza vaccine AND at least one Tdap vaccine during the pregnancy (including on the delivery date).
DENOMINATOR:
All deliveries in the measurement period for non-excluded patients.
EXCLUSIONS:
- Patients with deliveries with a gestational age of less than 37 weeks; or
- Patients who are in hospice or using hospice services between 1/1/2020 and delivery; or
- Patients with known medical exclusions to influenza or Tdap vaccine, including known allergy or prior reaction.
COMMON NUMERATOR CODES
There is a large list of NCQA codes used to identify the services included in the measure. Please refer to please refer to the NCQA website at www.ncqa.org for a complete list. Below is a list of the most common codes.
ADULT INFLUENZA VACCINE PROCEDURE
CPT Codes: 90630; 90653; 90654; 90656; 90658; 90661; 90673; 90674; 90882; 90686; 90688; 90689; 90756
ADULT INFLUENZA IMMUNIZATION
CVX Codes: 88; 140; 141; 144; 150; 153; 155; 158; 166; 168; 171; 185; 186
Tdap VACCINE PROCEDURE:
CPT Code: 90715
Tdap IMMUNIZATION:
CVX Code: 115