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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 (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 786846001 866186002 866227002 868266002 868267006 868268001 868273007 868274001 868276004 868277008 870670004 572561000119108 16290681000119103

  • DTaP Immunization

    CVX 20 50 106 107 110 120 146

    DTaP Vaccine Procedure

    CPT 90697 90698 90700 90723

    SNOMED CT US Edition  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 866158005 866159002 866226006 428251000124104   571571000119105   572561000119108   16290681000119103 16298561000119108

  • Haemophilus Influenzae Type B (HiB) Immunization

    CVX 17 46 47 48 49 50 51 120 146 148

    Haemophilus Influenzae 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 770608009 770616000 770617009 770618004 786846001 787436003 787438002 16292241000119109

  • 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

    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 170434002 170435001 170436000 170437009 312868009 396456003 770608009 770616000 770617009 770618004 786846001 787438002 572561000119108

    Newborn Hepatitis B Vaccine Administered

    ICD10PCS 3E0234Z 99.55

  • 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 313188000 313189008 314177003 314178008 314179000 394691002 412742005 412743000 871752004 871753009 871754003 571511000119102

  • Influenza Immunization

    CVX 88 140 141 150 153 155 158 161

    Influenza Vaccine Procedure

    CPT 90655 90657 90661 90673 90685 90686 90687 90688 90689

    HCPCS G0008

    SNOMED CT US Edition 86198006 786847005 787016008

    Influenza Virus LAIV Immunization

    CVX 111 149

    Influenza Virus LAIV Vaccine Procedure

    CPT 90660 90672

  • Measles, Mumps and Rubella (MMR) Immunization

    CVX 03 94

    Measles, Mumps and Rubella (MMR) Vaccine Procedure

    CPT 90707 90710

    SNOMED CT US Edition 38598009 170433008 432636005 433733003 150971000119104   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 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

  • Pneumococcal Conjugate Immunization
    CVX    109 133 152

    Pneumococcal Conjugate Vaccine Procedure
    CPT
        90670
    HCPCS    G0009
    SNOMED CT US Edition    434751000124102

  • Rotavirus (2 Dose Schedule) Immunization

    CVX 119

    Rotavirus Vaccine (2 Dose Schedule) Procedure

    CPT 90681

    Rotavirus (3 Dose Schedule) Immunization

    CVX 116 122

    SNOMED CT US Edition 434741000124104

    Rotavirus Vaccine (3 Dose Schedule) Procedure

    CPT 90680

    SNOMED CT US Edition 434731000124109

  • Varicella Zoster (VZV) Immunization
    CVX    21 94

    Varicella Zoster (VZV) Vaccine Procedure
    CPT    90710 90716
    SNOMED CT US Edition    425897001 428502009 473164004 571611000119101

    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 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 16000791000119100 16000831000119106

Member meets compliance for this measure.