HEDIS Patient Chart Requirements

Our health plan partners have updated their data requirements for HEDIS reporting, affecting all doctors. Therefore, we have listed below the updated patient chart requirements for documented Diabetic Retinal Examinations (DRE). Please ensure to include all information in your clinical notes for proper documentation of the service.

  • (2) Member identifiers such as Member name and date of birth; or health plan identification number
  • Name of provider performing the eye exam
  • Provider credentials (MD, OD, DO)
  • Provider signature
    • Digitally signed documents are acceptable
    • If not digitally signed, in addition to the signature there should be a legible printed name of the practitioner
  • Type I Diabetes – Yes or No (E10.9 for type 1 with no retinopathy)
  • Type II Diabetes – Yes or No (E11.9 for type 2 with no retinopathy)
  • Diabetic Retinopathy – Negative or Positive
    • If positive, please specify the appropriate ICD-10 code

Your adherence to these requirements is greatly appreciated. Our Provider Solutions Team is available to assist with any questions regarding this notice via email, providers@myicarehealth.com, or phone (855) 373-7627.