Mount Carmel Health Partners HEDIS Tip Sheets | Page 25

HEDIS Tip Sheet
Medication Reconciliation Post Discharge
Definition: Percentage of members ages 18 and older who have had an acute or non-acute inpatient discharge on or
between January 1 st and December 1 st of the measurement year and for who medications were reconciled the date
of discharge through 30 day after discharge (31 total days).
Coding:
CPT 2
CPT4
1111F
99495
99496
Exclusions: Hospice care in the measurement year.
Chart Review Tip:
• Documentation of the medication reconciliation can be found in the recent office visit/progress or telephonic
note must include date of when medication reconciliation was completed.
• Current and discharge medications must be reviewed on the same date.
• Medication reconciliation can be completed by prescribing practitioner, clinical pharmacist or registered nurse.
• Documentation of both current and discharge medications, with notation indicating medications have been
reconciled by provider.
• Documentation of the current medications with a notation referencing the discharge medications were reviewed
or no changes since discharge or discontinue all discharge medications.
• Documentation of both current and discharge medications, with notation indicating medications have been
reconciled by provider.
Supplemental Data Tips
• Member with multiple discharges, medication reconciliation must be completed for each discharge.
• Evidence of discharge summary was completed from acute or non-acute inpatient facility must be present in the
medical record.
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