HEDIS Benchmarks and Coding Guidelines for Quality Care

This document is a coding booklet that outlines the HEDIS benchmarks and coding guidelines for quality care as established by Anthem Blue Cross and Blue Shield. It provides detailed information for providers contracted with Anthem to serve various health plans in Indiana. The booklet includes specific measures related to healthcare quality, such as the Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis, which assesses the percentage of patients aged three months and older diagnosed with acute bronchitis who did not receive antibiotics. It also lists various codes and guidelines for reporting and documentation purposes. The information is based on the HEDIS MY2025 technical specifications and is subject to change according to the National Committee for Quality Assurance (NCQA) and other regulatory bodies. Providers are encouraged to follow these guidelines to ensure quality care and compliance with reporting standards.