HEDIS® CPT II Coding
Quick reference guide
What is HEDIS?
Healthcare Effectiveness Data and Information Set (HEDIS), is a set of more than 90 standardized performance measures used to annually evaluate and compare the performance of health plans. Data for these measures are collected using administrative/claims information and also Member medical record information. HEDIS results are used to identify opportunities for improving healthcare.
Why is using CPT II codes important?
Using Current Procedural Terminology (CPT II) when submitting claims can help you:
- Optimize proper documentation and monitoring care outcomes effectively.
- Minimize medical record request and maximize gaps in care closure and interventions.
- Improve communication and data capture across different settings of care.