Childhood Immunization Status (CIS) (CIS-E)
HEDIS Measure
Childhood Immunization Status (CIS) (CIS-E)
Line of business: Commercial Medicaid
Data Collection Method:
CIS
Administrative (Claims)
Hybrid (HEDIS Chart Chase)
Supplemental Data Submission
- Standard - Electronic Clinical Data (ECDS) Layout
- Non-Standard - Medical Record
CIS-E
Administrative (Claims)
Supplemental Data Submission
- Standard - Electronic Clinical Data System (ECDS) Layout
- Non-Standard - Medical Record
Measure Description
The 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. The measure calculates a rate for each vaccine and three combination rates.
Numerator Compliance
DTaP, IPV, HiB, pneumococcal conjugate, rotavirus and influenza
Evidence of the antigen or combination vaccine. For combination vaccinations that require more than one antigen (i.e., DTaP and MMR), there must be evidence of all the antigens.
DTaP: At least four DTaP 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.
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.
MMR: Any of the following meet criteria:
At least one MMR vaccination on or between the child’s first and second birthdays.
At least one measles and rubella vaccination and one of the following:
- At least one mumps vaccination on or between the child’s first and second birthdays.
- History of mumps illness (Mumps Value Set) any time on or before the child’s second birthday.
Any combination of codes below that indicates evidence of all three antigens (on the same or different date of service).
- At least one measles vaccination administered on or between the child’s first and second birthdays
- History of measles illness anytime on or before the child’s second birthday.
- At least one mumps vaccination administered on or between the child’s first and second birthdays OR history of mumps illness anytime on or before the child’s second birthday.
- At least one rubella vaccination administered on or between the child’s first and second birthdays OR History of rubella illness anytime on or before the child’s second birthday.
HiB: At least three HiB vaccinations with different dates of service on or before the child’s second birthday. Do not count a vaccine administered prior to 42 days after birth.
Hepatitis B: 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.
- History of hepatitis illness
VZV: Either of the following on or between the child’s first and second birthdays 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 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: Either of the following on or between the child’s first and second birthdays 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: Any of the following on or before the child’s second birthday meet criteria. Do not count a vaccination administered prior to 42 days after birth.
- At least two doses of the two-dose rotavirus vaccine on different dates of service.
- At least three doses of the three-dose rotavirus vaccine on different dates of service.
- 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.
NOTE: If the medical record does not indicate 2 or 3 dose, it is assumed to be a 3 dose series.
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.
NOTE: LAIV vaccination will only be counted if administered on the child’s second birthday.
Best Practices
- Schedule appointments to coincide with required timeframes for immunization administration
- Use your electronic medical record (EMR) system to set reminder flags
- During visits, talk to parents about the importance of having their children immunized
- Ensure the member’s medical record includes immunization history from all sources (NOTE: “Child is up to date with all immunizations” does not meet compliance)
- Update the New Jersey Immunization Information System registry
- Reference the CDC Immunization Vaccine Schedule: cdc.gov/vaccines/schedules
Quality Value Set Directory Coding Tips
DTaP
DTaP Immunization
CVX
- 20
- 50
- 106
- 107
- 110
- 120
- 146
DTaP Vaccine Procedure
CPT
- 90697
- 90698
- 90700
- 90723
SNOMED CT US Edition
- 310306005
- 310307001
- 310308006
- 312870000
- 313383003
- 390846000
- 390865008
- 399014008
- 412755006
- 412756007
- 412757003
- 412762002
- 412763007
- 412764001
- 414001002
- 414259000
- 414620004
- 415507003
- 415712004
- 770608009
- 770616000
- 770617009
- 770618004
- 787436003
- 866158005
- 866159002
- 866226006
- 868273007
- 868274001
- 868276004
- 868277008
- 1162640003
- 428251000124104
- 571571000119105
- 572561000119108
- 16290681000119103
HIB B
Haemophilus Influenza Type B (HiB) Immunization
CVX
- 17
- 46
- 47
- 48
- 49
- 50
- 51
- 120
- 146
- 148
Haemophilus Influenza Type B (HiB) Vaccine Procedure
CPT
- 90644
- 90647
- 90648
- 90697
- 90698
- 90748
SNOMED CT US Edition
- 127787002
- 170343007
- 170344001
- 170345000
- 170346004
- 310306005
- 310307001
- 310308006
- 312869001
- 312870000
- 414001002
- 414259000
- 415507003
- 415712004
- 428975001
- 712833000
- 712834006
- 770608009
- 770616000
- 770617009
- 770618004
- 786846001
- 787436003
- 1119364007
- 1162640003
- 16292241000119109
HEP A
Hepatitis A (Illness)
ICD10CM
- B15.0
- B15.9
SNOMED CT US Edition
- 16060001
- 18917003
- 25102003
- 40468003
- 43634002
- 79031007
- 111879004
- 165997004
- 206373002
- 278971009
- 310875001
- 424758008
- 428030001
- 105801000119103
Hepatitis A Immunization
CVX
- 31
- 83
- 85
Hepatitis A Vaccine Procedure
CPT
- 90633
SNOMED CT US Edition
- 170378007
- 170379004
- 170380001
- 170381002
- 170434002
- 170435001
- 170436000
- 170437009
- 243789007
- 312868009
- 314177003
- 314178008
- 314179000
- 394691002
- 871752004
- 871753009
- 871754003
- 571511000119102
HEP B
Hepatitis B (Illness)
ICD10CM
- B16.0
- B16.1
- B16.2
- B16.9
- B17.0
- B18.0
- B18.1
- B19.10
- B19.11
SNOMED CT US Edition
- 1116000
- 13265006
- 26206000
- 38662009
- 50167007
- 53425008
- 60498001
- 61977001
- 66071002
- 76795007
- 111891008
- 165806002
- 186624004
- 186626002
- 186639003
- 235864009
- 235865005
- 235869004
- 235871004
- 271511000
- 313234004
- 406117000
- 424099008
- 424340000
- 442134007
- 442374005
- 446698005
- 838380002
- 153091000119109
- 551621000124109
Hepatitis B Immunization
CVX
- 08
- 44
- 45
- 51
- 110
- 146
Hepatitis B Vaccine Procedure
CPT
- 90697
- 90723
- 90740
- 90744
- 90747
- 90748
HCPCS
- G0010
SNOMED CT US Edition
- 16584000
- 170370000
- 170371001
- 170372008
- 170373003
- 170374009
- 170375005
- 170434002
- 170435001
- 170436000
- 170437009
- 312868009
- 396456003
- 770608009
- 770616000
- 770617009
- 770618004
- 786846001
- 1162640003
- 572561000119108
Newborn Hepatitis B Vaccine Administered
ICD10PCS
- 3E0234Z
- 99.55
POLIO
Inactivated Polio Vaccine (IPV) Immunization
CVX
- 10
- 89
- 110
- 120
- 146
Inactivated Polio Vaccine (IPV) Procedure
CPT
- 90697
- 90698
- 90713
- 90723
SNOMED CT US Edition
- 310306005
- 310307001
- 310308006
- 312869001
- 312870000
- 313383003
- 390865008
- 396456003
- 412762002
- 412763007
- 412764001
- 414001002
- 414259000
- 414619005
- 414620004
- 415507003
- 415712004
- 416144004
- 416591003
- 417211006
- 417384007
- 417615007
- 866186002
- 866227002
- 868266002
- 868267006
- 868268001
- 868273007
- 868274001
- 868276004
- 868277008
- 870670004
- 572561000119108
- 16290681000119103
FLU
Influenza Immunization
CVX
- 88
- 140
- 141
- 150
- 153
- 155
- 158
- 161
- 171
- 186
Influenza Vaccine Procedure
CPT
- 90655
- 90657
- 90661
- 90673
- 90685
- 90686
- 90687
- 90688
- 90689
- 90756
HCPCS
- G0008
SNOMED CT US Edition
- 86198006
Influenza Virus LAIV Immunization
CVX
- 111
- 149
Influenza Virus LAIV Vaccine Procedure
CPT
- 90660
- 90672
SNOMED CT US Edition
- 787016008
MMR
Measles, Mumps and Rubella (MMR) Immunization
CVX
- 03
- 94
Measles, Mumps and Rubella (MMR) Vaccine Procedure
CPT
- 90707
- 90710
SNOMED CT US Edition
- 38598009
- 170431005
- 170432003
- 170433008
- 432636005
- 433733003
- 871909005
- 571591000119106
- 572511000119105
Mumps (Illness)
ICD10CM
- B26.0
- B26.1
- B26.2
- B26.3
- B26.81
- B26.82
- B26.83
- B26.84
- B26.85
- B26.89
- B26.9
SNOMED CT US Edition
- 10665004
- 17121006
- 31524007
- 31646008
- 36989005
- 40099009
- 44201003
- 63462008
- 72071001
- 74717002
- 75548002
- 78580004
- 89231008
- 89764009
- 111870000
- 161420006
- 235123001
- 236771002
- 237443002
- 240526004
- 240527008
- 240529006
- 371112003
- 1163539003
- 105821000119107
Measles (Illness)
ICD10CM
- B05.0
- B05.1
- B05.2
- B05.3
- B05.4
- B05.81
- B05.89
- B05.9
SNOMED CT US Edition
- 14189004
- 28463004
- 38921001
- 60013002
- 74918002
- 111873003
- 161419000
- 186561002
- 186562009
- 195900001
- 240483006
- 240484000
- 359686005
- 371111005
- 406592004
- 417145006
- 424306000
- 105841000119101
Rubella (Illness)
ICD10CM
- B06.00
- B06.01
- B06.02
- B06.09
- B06.81
- B06.82
- B06.89
- B06.9
SNOMED CT US Edition
- 10082001
- 13225007
- 19431000
- 36653000
- 51490003
- 64190005
- 79303006
- 128191000
- 161421005
- 165792000
- 186567003
- 186570004
- 192689006
- 231985001
- 232312000
- 240485004
- 253227001
- 406112006
- 406113001
- 1092361000119109
- 10759761000119100
PCV
Pneumococcal Conjugate Immunization
CVX
- 109
- 133
- 152
Pneumococcal Conjugate Vaccine Procedure
CPT
- 90670
HCPCS
- G0009
SNOMED CT US Edition
- 1119368005
- 434751000124102
ROTAVIRUS
Rotavirus (2 Dose Schedule) Immunization
CVX
- 119
Rotavirus Vaccine (2 Dose Schedule) Procedure
CPT
- 90681
Rotavirus (3 Dose Schedule) Immunization
CVX
- 116
- 122
Rotavirus Vaccine (3 Dose Schedule) Procedure
CPT
- 90680
SNOMED CT US Edition
- 434731000124109
VARICELLA
Varicella Zoster (VZV) Immunization
CVX
- 21
- 94
Varicella Zoster (VZV) Vaccine Procedure
CPT
- 90710
- 90716
SNOMED CT US Edition
- 425897001
- 428502009
- 432636005
- 433733003
- 737081007
- 871898007
- 871899004
- 871909005
- 572511000119105
Varicella Zoster (Illness)
ICD10CM
- B01.0
- B01.11
- B01.12
- B01.2
- B01.81
- B01.89
- B01.9
- B02.0
- B02.1
- B02.21
- B02.22
- B02.23
- B02.24
- B02.29
- B02.30
- B02.31
- B02.32
- B02.33
- B02.34
- B02.39
- B02.7
- B02.8
- B02.9
SNOMED CT US Edition
- 4740000
- 10698009
- 21954000
- 23737006
- 24059009
- 36292003
- 38907003
- 42448002
- 49183009
- 55560002
- 87513003
- 111859007
- 111861003
- 161423008
- 186524006
- 186525007
- 195911009
- 230176008
- 230198004
- 230262004
- 230536009
- 232400003
- 235059009
- 240468001
- 240470005
- 240471009
- 240472002
- 240473007
- 240474001
- 309465005
- 371113008
- 397573005
- 400020001
- 402897003
- 402898008
- 402899000
- 410500004
- 410509003
- 421029004
- 422127002
- 422446008
- 422471006
- 422666006
- 423333008
- 423628002
- 424353002
- 424435009
- 424801004
- 424941009
- 425356002
- 426570007
- 428633000
- 713250002
- 713733003
- 713964006
- 715223009
- 723109003
- 838357005
- 1163465001
- 1163483009
- 1179456002
- 12551000132107
- 12561000132105
- 12571000132104
- 98541000119101
- 331071000119101
- 681221000119108
- 1087131000119102
- 15678761000119105
- 15678801000119102
- 15678841000119100
- 15680201000119106
- 15680241000119108
- 15680281000119103
- 15685081000119102
- 15685121000119100
- 15685201000119100
- 15685281000119108
- 15936581000119108
- 15936621000119108
- 15989271000119107
- 15989311000119107
- 15989351000119108
- 15991711000119108
- 15991751000119109
- 15991791000119104
- 15992351000119104
- 16000751000119105
- 16000791000119100
- 16000831000119106