Posted in HEDIS Measures, Training, Updates

HEDIS Measure: Cervical Cancer Screening

Description:

Cervical cancer screening is measured by the percentage of women, 21 to 64 years of age who were screened for cervical cancer using either of the following criteria:

  • Women 21 to 64 years of age who had cervical cytology performed within the last 3 years.
  • Women 30 to 64 years of age who had cervical high-risk human papillomavirus (hrHPV) testing performed within the last 5 years.
  • Women 30 to 64 years of age who had cervical cytology/high-risk human papillomavirus (hrHPV) co-testing within the last 5 years.

Note: Evidence of hrHPV testing within the past five years also captures patients who had co-testing; therefore, additional methods to identify co-testing are not necessary.


Documentation:

  1. For women age 24-64 as of Dec. 31 of the measurement year who had cervical cytology
    during the measurement year or the two years prior to the measurement year, documentation
    in the medical record must include both of the following:
    o A note indicating the date when the cervical cytology was performed
    o The result or finding

2. For women age 30-64 as of Dec. 31 of the measurement year who: 1) had cervical hrHPV
testing during the measurement year or the four years prior to the measurement years, and 2)
were 30 years or older as of the date of testing, documentation must include both:
o A note indicating the date the hrHPV test was performed; generic documentation stating
HPV test counts as evidence of hrHPV test
o The results or findings

Documentation that will not be accepted for this measure:

  1. Biopsies do not count
  2. Lab results that state the sample was inadequate or that no cervical cells were present are
    not acceptable unless it is also stated this finding is consistent with a hysterectomy
  3. Documenting hysterectomy is not sufficient; should note if the hysterectomy resulted in the
    loss of the cervix and include terms like total, complete or radical hysterectomy

Codes that apply to this HEDIS Measure

Exclusions:

1.Women who have had a total, complete or radical vaginal or abdominal hysterectomy with no
residual cervix, cervical agenesis or acquired absence of cervix; prior to Dec. 31 of the
measurement year
2. Hospice or palliative care during measurement years
3. Documentation of vaginal hysterectomy meets criteria for documentation of hysterectomy with
no residual cervix



HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
All summaries of the measures contained herein are reproduced w ith permission from HEDIS MY2020 and MY2021, Volume 2: Technical Specifications for Health Plans by the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).


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HEDIS Measure: Colorectal Cancer Screening (COL)

This HEDIS® measure evaluates the percentage of patients age 50 to 75 who had appropriate screening for colorectal cancer.

In order for PCPs to get credit for this Measure they need to document the following:

Document (date and result) one or more of these screenings:

  • Colonoscopy during measurement year or nine years prior
  • Fecal occult blood test (FOBT) during measurement year
  • CT colonography during measurement year or four years prior
  • Fecal immunochemical test (FIT)-DNA test during measurement year or two years prior
  • Flexible sigmoidoscopy during measurement year or four years prior

There following are exclusions for this measure:

  • Diagnosis of colorectal cancer
  • Total colectomy
  • Members who receive palliative 

Quest Test available:

There is an option for your patient to get a FIT kits through Quest Diagnostics.®* This option is only available for PARTICIPATING providers.

Quest will ship InSure® ONE™ FIT kits directly to your practice. There are 2 ways to order:

  • Online, use the Quest Quanum® Lab Services Manager. Create an account at https://bit.ly/3qLxNPh.
  • Via phone, call 1-866-MY-QUEST and state supplies for assistance.

Quest will ship the kits to your practice at no cost, based on usage and test completion.