Product Lines:
EHP, Priority Partners, and USFHP.

Eligible Population:
Adolescents 13 years of age during the measurement year.

Definition:
Adolescents 13 years of age who had one-dose of meningococcal vaccine, one-dose tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) and completed the human papillomavirus (HPV) vaccine series by their 13th birthday.

Combo 1:

• 1 dose – Meningococcal conjugate or meningococcal polysaccharide vaccine on or between the member’s 11th and 13th birthdays.
• 1 dose – Tetanus, diphtheria toxoids vaccine, and acellular pertussis vaccine (Tdap) on or between the member’s 10th and 13th birthdays.

Combo 2 (includes above combo 1 immunizations plus the following):

• 2 dose series or 3 dose series of the HPV (human papilloma virus) vaccine with different dates of service between the members 9th and 13th birthdays.

Report stratification by race and ethnicity.

Continuous Enrollment:

• 12 months prior to the member’s 13th birthday.

Best Practice and Measure Tips

• Immunization must occur on or prior to the member’s 13th birthday.
• Document any parent refusal for immunizations, as well as anaphylactic reactions. There must be a note indicating the date of the event occurring by the member’s 13th birthday. This will not exclude the member from this measure.
• The below count towards compliance. There must be a note indicating the date of the event occurring by the member’s 13th birthday.
  • For ALL vaccines:
    • Anaphylaxis due to the vaccine.
    • Evidence of the antigen or combination vaccine.
  • Tdap: Encephalopathy
• For the two-dose HPV vaccination series, there must be at least 146 days (5 months) between the first and second dose of the HPV vaccine.

Acceptable documentation:

• A note indicating the name of the specific antigen and the date of the immunization.
• A certificate of immunization prepared by an authorized health care provider or agency including the specific dates and types of immunizations administered.

Not acceptable:

• A note the "member is up to date" with all immunizations but does not list the dates and names of all immunizations.
• Meningococcal recombinant (serogroup B) (MenB) vaccines.

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year.
• Members who died any time during the measurement year.

Measure Codes

• Meningococcal-serogroup A,C,W, and Y(1 dose) 
  • CPT: 90619, 90733, 90734 
  • CVX: 32, 108, 114, 136, 147, 167, 203
  • Anaphylaxis due to the meningococcal vaccine SNOMED CT code: 428301000124106
• Tdap (1 dose) 
  • CPT: 90715
  • CVX: 115
  • Anaphylaxis Due to Diphtheria, Tetanus or Pertussis Vaccine SNOMED CT code: 428281000124107, 428291000124105
  • Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine SNOMED CT code: 192710009, 192711008, 192712001
• HPV (2 or 3 dose series) 
  • CPT: 90649 – 90651
  • CVX: 62, 118, 137, 165
  • Anaphylaxis due to the HPV vaccine SNOMED CT code: 428241000124101