CMS 117 - Childhood Immunization Status

• Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
• Create a note detailing the patient’s office visit.

1. Severe combined immunodeficiency
2. Immunodeficiency
3. HIV
4. Lymphoreticular cancer, multiple myeloma or leukemia
5. Intussusception

• These conditions are documented under Problems with a Start Date.

Exclude children who are in hospice care for any part of the measurement period.

• Hospice is documented under Hospice in History. These patients will be excluded from the denominator.

1. At least four DTaP vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.
2. Anaphylaxis due to the diphtheria, tetanus or pertussis vaccine.
3. Encephalitis due to the diphtheria, tetanus or pertussis vaccine.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.
• Illness, conditions, or history os illness is documented under Problems with a Start Date.

Poliovirus vaccination (IPV)

Children with either of the following on or before the child’s second birthday meet criteria:

1. At least three IPV vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.
2. Anaphylaxis due to the IPV vaccine.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.

Measles, mumps, and rubella vaccination (MMR)

Children with any of the following meet criteria:

1. At least one MMR vaccination on or between the child’s first and second birthdays.
2. Anaphylaxis due to the MMR vaccine on or before the child’s second birthday.
3. All of the following anytime on or before the child’s second birthday (on the same or different date of service):
   • History of measles
   • History of mumps
   • History of rubella

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.
• Illness, conditions, or history of illness is documented under Problems with a Start Date.

Haemophilus influenzae type b vaccination (HiB)

Children with either of the following meet criteria on or before the child’s second birthday:

1. At least three HiB vaccinations, with different dates of service. Do not count a vaccination administered prior to 42 days after birth.
2. Anaphylaxis due to the HiB vaccine.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.

Hepatitis B (Hep B)

Children with any of the following on or before the child’s second birthday meet criteria:

1. At least three hepatitis B vaccinations, with different dates of service.
   • One of the three vaccinations can be a newborn hepatitis B vaccination during the eight-day period that begins on the date of birth and ends seven days after the date of birth. For example, if the member’s date of birth is December 1, the newborn hepatitis B vaccination must be on or between December 1 and December 8.
2. Anaphylaxis due to the hepatitis B vaccine.
3. History of hepatitis B illness.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.
• Illness, conditions, or history of illness is documented under Problems with a Start Date.

Varicella vaccination (VZV)

Children with any of the following meet criteria:

1. At least one VZV vaccination, with a date of service on or between the child’s first and second birthdays.
2. Anaphylaxis due to the VZV vaccine on or before the child’s second birthday.
3. History of varicella zoster (e.g., chicken pox) illness on or before the child’s second birthday.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.
• Illness, conditions, or history of illness is documented under Problems with a Start Date.

Pneumococcal Conjugate (PCV)

Children with either of the following on or before the child’s second birthday meet criteria:

1. At least four pneumococcal conjugate vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.
2. Anaphylaxis due to the pneumococcal vaccine

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.

Hepatitis A (Hep A)

Children with any of the following meet criteria:

1. At least one hepatitis A vaccination, with a date of service on or between the child’s first and second birthdays.
2. Anaphylaxis due to the hepatitis A vaccine on or before the child’s second birthday.
3. History of hepatitis A illness on or before the child’s second birthday

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.
• Illness, conditions, or history of illness is documented under Problems with a Start Date.

Rotavirus (RV)

Children with any of the following meet criteria:

1. At least two doses of the two-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.
2. At least three doses of the three-dose rotavirus vaccine on different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.
3. At least one dose of the two-dose rotavirus vaccine and at least two doses of the three-dose rotavirus vaccine, all on different dates of service, on or before the child’s second birthday. Do not count a vaccination administered prior to 42 days after birth.
4. Anaphylaxis due to the rotavirus vaccine on or before the child’s second birthday.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.

Influenza (Flu)

Children with either of the following on or before their second birthday meet Criteria:

1. At least two influenza vaccinations, with different dates of service on or before the child’s second birthday. Do not count a vaccination administered prior to 6 months (180 days) after birth.
2. One of the two vaccinations can be an LAIV vaccination administered on the child’s second birthday. Do not count an LAIV vaccination administered before the child’s second birthday.
3. Anaphylaxis due to the influenza vaccine.

• Vaccines are documented in Immunizations. Vaccine may be entered as Administer New or Add Historical. Enter an Order or Recorded Date for each immunization.
• Allergic reactions to vaccines are documented under Allergies with a Start Date.

• Enter Procedure Codes including E/M Codes, HCPCS, or CPT Codes as applicable on the Charge Capture
• Complete and sign the note

Once all steps have been completed, the measure will be added to the Quality Measures Report.