September 29, 2020
We’ve added two additional behavioral health tip sheets to help you satisfy Healthcare Effectiveness Data and Information Set (HEDIS) measures and code claims appropriately:
- Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
These measures from the National Committee for Quality Assurance (NCQA) serve as a quality improvement tool to help ensure our members receive appropriate care.
The tip sheets include measurement requirements, medical record best practices and billing codes.
This measure evaluates members 13 years old and older who had an emergency department (ED) visit with the principal diagnosis of alcohol and other drug (AOD) abuse or dependence. It evaluates the percentage of members who had follow-up visits within 7 and 30 days of the ED visit.
This measure evaluates members 6 years old and older who had an ED visit for mental illness. It evaluates the percentage of members who had follow-up visits within 7 and 30 days of the ED visit.
* Measurement Year (MY) 2020 and MY 2021
HEDIS is a registered trademark of the NCQA.
The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.