This article is for primary care providers, allergists, and pulmonologists caring for our members
While asthma affects almost 25 million people in the United States, disparities lie heavily in Black and Hispanic communities. You play a crucial role in supporting your patients with asthma by making sure they understand their condition and treatment plan.
Tips for HEDIS®'' Improvement
As you know, the asthma action plan helps your patient understand their triggers and the appropriate medication to take. When creating this plan be sure to:
While the asthma medication ratio HEDIS measure looks at members with persistent asthma, certain comorbid conditions such as emphysema, COPD, and obstructive chronic bronchitis can exclude them from the measure.
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|
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Condition |
ICD-10-CM code |
Acute respiratory failure |
J96.00-J96.02, J96.20-J96.22 |
Chronic obstructive pulmonary disease (COPD) |
J44.0, J44.1, J44.9 |
Chronic respiratory conditions due to fumes or vapors |
J68.4 |
Cystic fibrosis |
E84.0, E84.11, E84.19, E84.8, E84.9 |
Emphysema |
J43.0-J43.2, J43.8, J43.9, J98.2, J98.3 |
Obstructive chronic bronchitis |
491.20-491.22 (ICD-9-CM) |
Other emphysema |
J98.2-J98.3 |
Note that the list above is not exhaustive, but a sample of diagnosis codes that may be used.
Coding HEDIS exclusions for comorbid conditions, when applicable, improves performance rates by excluding these members. This can also eliminate the need to submit patient medical records during HEDIS record collection, saving your staff time and resources.