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COVID-19

Childhood Immunization Status (CIS) (Combination 10) – HEDIS Measure

Answer the questions to confirm eligibility and compliance criteria, this is applicable to Medicaid and Commercial members only.

Does the member* turn 2 years of age during the measurement year?

Does the member have ALL of the following vaccinations (Combination 10*) administered or documentation of history of the illness, as applicable, on or before his/her 2nd birthday?

Documentation of:

  • 4 DTaP vaccinations
  • 3 IPV vaccinations
  • 1 MMR vaccination (or history of illness)
  • 3 HiB vaccinations (Haemophilus Influenzae Type B)
  • 3 Hepatitis B vaccinations (or history of illness)
  • 1 Varicella vaccination (VZV) (or history of illness)
  • 4 Pneumococcal Conjugate vaccinations
  • 1 Hepatitis A vaccination (or history of illness)
  • 2-dose or 3-dose Rotavirus vaccinations**
  • 2 Influenza vaccinations

Member does not meet compliance for this measure

How to meet compliance

For a member to meet compliance for this measure, have ALL of the following vaccinations (Combination 10) administered or documentation of history of the illness, as applicable on or before his/her 2nd birthday.

Billing Codes

  • Inactivated Polio Vaccine Administered
    CPT® CVX SNOMED CT
    90698, 90713, 90723 10, 89, 110, 120 396456003, 414001002, 414259000, 414619005, 414620004, 415507003, 415712004, 416144004, 416591003, 417211006, 417384007, 417615007
  • DTaP Vaccine Administered
    CPT® CVX SNOMED CT
    90698, 90700, 90723 20, 50, 106, 107, 110, 120 170395004, 170396003, 170397007, 170399005, 170400003, 170401004, 170402006, 310306005, 310307001, 310308006, 312870000, 313383003, 390846000, 390865008, 399014008, 412755006, 412756007, 412757003, 412762002, 412763007, 412764001, 414001002, 414259000, 414620004, 415507003, 415712004, 770608009, 770616000, 770617009, 770618004, 787436003, 787438002, 428251000124104, 571571000119105, 572561000119108, 16290681000119103, 16298561000119108
  • HiB Vaccine Administered
    CPT® CVX SNOMED CT
    90644, 90647, 90648, 90698, 90748 17, 46, 47, 48, 49, 50, 51, 120, 148 127787002, 170343007, 170344001, 170345000, 170346004, 310306005, 310307001, 310308006, 312869001, 312870000, 414001002, 414259000, 415507003, 415712004, 770608009, 770616000, 770617009, 770618004, 786846001, 787436003, 787438002
  • Hepatitis B Vaccine Administered
    CPT® CVX HCPCS SNOMED CT
    90723, 90740, 90744, 90747, 90748 08, 44, 45, 51, 110 G0010 16584000, 170370000, 170371001, 170372008, 170373003, 170434002, 170435001, 170436000, 170437009, 312868009, 396456003, 770608009, 770616000, 770617009, 770618004, 786846001, 787438002, 572561000119108
    Hepatitis B illness
    ICD10CM SNOMED CT:
    B16.0, B16.1, B16.2, B16.9, B17.0, B18.0, B18.1, B19.10, B19.11 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, 153091000119109
    Newborn Hepatitis B Vaccine Administered
    ICD9PCS: SNOMED CT: ICD10:
    99.55 170370000, 426980004 3E0234Z
  • Pneumococcal Conjugate Vaccine Administered
    CPT® CVX HCPCS SNOMED CT
    90670 133, 152 G0009 434751000124102
  • Varicella Zoster Vaccine Administered
    CPT® CVX SNOMED CT
    90710, 90716 21, 94 425897001,428502009, 473164004, 571611000119101
    Varicella Zoster illness
    ICD10CM SNOMED CT:
    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 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, 12551000132107, 12561000132105, 12571000132104, 331071000119101, 681221000119108, 15678761000119105, 15678801000119102, 15680201000119106, 15685201000119100, 15685281000119108, 15680241000119108, 15685081000119102, 15685121000119100, 15936581000119108, 15936621000119108, 15989271000119107, 15989311000119107, 15989351000119108, 15991711000119108, 15991791000119104
  • Hepatitis A Vaccine Administered
    CPT® CVX SNOMED CT
    90633 31, 83, 85 170378007, 170379004, 170380001, 170381002, 170434002, 170435001, 170436000, 170437009, 243789007, 312868009, 313188000, 313189008, 314177003, 314178008, 314179000, 394691002, 412742005, 412743000, 571511000119102
    Hepatitis A illness
    ICD10CM SNOMED CT:
    B15.0, B15.9 16060001, 18917003, 25102003, 40468003, 43634002, 79031007, 111879004, 165997004, 206373002, 278971009, 310875001, 424758008, 428030001, 105801000119103
  • Influenza Vaccine Administered
    CPT® CVX HCPCS SNOMED CT
    90655, 90657, 90661, 90673, 90685, 90686, 90687, 90688, 90660, 90672, 90689 88, 140, 141, 150, 153, 158, 161, 111, 149, 155 G0008 86198006, 786847005; 787016008
    Influenza Virus LAIV Immunization
    CVX
    111, 149
    Influenza Virus LAIV Vaccine Procedure
    CPT®
    90660, 90672
  • MMR Vaccine Administered
    CPT® CVX SNOMED CT
    90707, 90710 03, 94 38598009, 170433008, 432636005, 433733003, 150971000119104, 571591000119106, 572511000119105
    Measles/Rubella Vaccine Administered
    CPT® CVX
    90708 04
  • Measles Vaccine Administered
    CPT® CVX SNOMED CT
    90705 05 47435007, 170364006, 572481000119103
    Measles illness
    ICD10CM SNOMED CT:
    B05.0, B05.1, B05.2, B05.3, B05.4, B05.81, B05.89, B05.9 14189004, 28463004, 38921001, 60013002, 74918002, 111873003, 161419000, 186561002, 186562009, 195900001,240483006, 240484000, 371111005, 406592004, 417145006, 105841000119101
  • Mumps Vaccine Administered
    CPT® CVX SNOMED CT
    90704 07 50583002
    Mumps illness
    ICD10CM SNOMED CT:
    B26.0, B26.1, B26.2, B26.3, B26.81, B26.82, B26.83, B26.84, B26.85, B26.89, B26.9 SNOMED: 10665004, 17121006, 31524007, 31646008, 36989005, 40099009, 44201003, 63462008, 72071001, 74717002, 75548002, 78580004, 89231008, 89764009, 111870000, 161420006, 235123001, 236771002, 237443002, 240526004, 240527008, 240529006, 371112003, 105821000119107
  • Rotavirus Vaccine (2 Dose Schedule) Administered
    CPT® CVX SNOMED CT
    90681 119 434741000124104
    Rotavirus Vaccine (3 Dose Schedule) Administered
    CPT® CVX SNOMED CT
    90680 116, 122 434731000124109
  • Rubella Vaccine Administered
    CPT® CVX SNOMED CT
    90706 06 82314000
    Rubella illness
    ICD10 SNOMED CT:
    B06.00, B06.01, B06.02, B06.09, B06.81, B06.82, B06.89, B06.9 10082001, 13225007, 19431000, 36653000, 51490003, 64190005, 79303006, 84611003, 111867004, 128191000, 161421005, 165792000, 186567003, 186570004, 192689006, 231985001, 232312000, 240485004, 253227001, 406112006, 406113001, 1092361000119109, 10759761000119100
    Rubella Antibody
    CPT®
    86762

Member meets compliance for this measure.