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

DTaP Vaccine Procedure

HIB B

Haemophilus Influenza Type B (HiB) Immunization

Haemophilus Influenza Type B (HiB) Vaccine Procedure

HEP A

Hepatitis A (Illness)

Hepatitis A Immunization

Hepatitis A Vaccine Procedure

HEP B

Hepatitis B (Illness)

Hepatitis B Immunization

Hepatitis B Vaccine Procedure

Newborn Hepatitis B Vaccine Administered

POLIO

Inactivated Polio Vaccine (IPV) Immunization

Inactivated Polio Vaccine (IPV) Procedure

FLU

Influenza Immunization

Influenza Vaccine Procedure

Influenza Virus LAIV Immunization

Influenza Virus LAIV Vaccine Procedure

MMR

Measles, Mumps and Rubella (MMR) Immunization

Measles, Mumps and Rubella (MMR) Vaccine Procedure

Mumps (Illness)

Measles (Illness)

Rubella (Illness)

PCV

Pneumococcal Conjugate Immunization

Pneumococcal Conjugate Vaccine Procedure

ROTAVIRUS

Rotavirus (2 Dose Schedule) Immunization

Rotavirus Vaccine (2 Dose Schedule) Procedure

Rotavirus (3 Dose Schedule) Immunization

Rotavirus Vaccine (3 Dose Schedule) Procedure

VARICELLA

Varicella Zoster (VZV) Immunization

Varicella Zoster (VZV) Vaccine Procedure

Varicella Zoster (Illness)