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Johns Hopkins Health Plans

CHL - Chlamydia Screening

Product Lines:
EHP, Priority Partners and USFHP.

Measurement Period: January 1 - December 31 

Description:
The percentage of persons 16–24 years of age who were recommended for routine chlamydia screening, were identified as sexually active and had at least one test for chlamydia during the measurement period.

Stratifications:
Age as of the last day of the measurement period.

  • 16–20 years.
  • 21–24 years.  

Measure Reporting:
HealthChoice Performance Measure reporting for Priority Partners.  

Improvement Notation:
Increased score indicates improvement.

Initial Population:

  • Measure Item Count: Person. 
  • Age: 16–24 years of age as of the last day of the measurement period.
  • Gender/sex criteria (persons recommended for routine chlamydia screening):
    • Administrative Gender of Female (AdministrativeGender code Female) any time in the person’s history. 
    • Sex assigned at birth (LOINC code 76689-9) of Female (Female Value Set) any time in the person’s history. 
    • Sex Parameter for Clinical Use of Female (SexParameterForClinicalUse code female-typical) during the measurement period.  
  • Benefits: Medical.
  • Continuous Enrollment: The measurement period.
  • Allowable Gap: No more than one gap of ≤45 days during the measurement period. No gaps on the last day of the measurement period.

Data Collection:

  • Administrative
  • Supplemental

Denominator:
Persons recommended for routine chlamydia screening.

  • Claim/encounter data. Persons with a claim or encounter indicating sexual activity during the measurement period. 
  • Pharmacy data. Persons with at least one contraceptive medication dispensing event during the measurement period. Acute inpatient discharge, residential treatment or withdrawal management event for a principal diagnosis of substance use disorder on or between January 1 and December 1 of the measurement period.

Numerator:
At least one chlamydia test during the measurement period. 

Best Practice and Measure Tips

  • Chlamydia screening may not be captured via claims if the service is performed and billed under prenatal and postpartum global billing.
  • May be either a urine analysis or vaginal swab from the same ThinPrep used for the Pap smear. Samples must be sent to the lab vendor for analysis.
  • Document in the medical record should indicate the date the test was performed and the result or finding, including any follow-ups.
  • Incorporate a sexual history into the History and Physical documentation in your EMR.
  • Have patient come in for their routine yearly visit and incorporate universal screening for all women in the age range.
  • A chlamydia screening should occur with or without symptoms.
  • Educate member about sexually transmitted diseases (STD), include signs, symptoms, and treatment.
  • For any visit where oral contraceptive, sexually transmitted diseases (STD) or urinary symptoms are discussed, a Chlamydia screening should occur.
  • Educate members about safe sex and abstinence.

Measure Exclusions

Denominator Exclusions:

  • Sex Assigned at Birth Male any time in the person's history through the last day of the measurement period.
  • Persons in hospice or using hospice services any time during the measurement period.
  • Persons who died any time during the measurement period.

Numerator Exclusions:

  • A pregnancy test during the measurement period and a prescription for isotretinoin on the date of the pregnancy test through 6 days after the pregnancy test. 
  • A pregnancy test during the measurement period and an x-ray on the date of the pregnancy test through 6 days after the pregnancy test.
  • Laboratory claims (POS code 81). 

Exclusion Codes

  • Sex assigned at birth LOINC: 76689-9
  • Male
    • LOINC: LA2-8
    • SNOMED CT US Edition: 248153007
  • Pregnancy Tests
    • CPT: 81025, 84702, 84703
    • LOINC: 19080-1, 19180-9, 20415-6, 20994-0, 2106-3, 2107-1, 2110-5, 2111-3, 2112-1, 2113-9, 2114-7, 2115-4, 2118-8, 2119-6, 21198-7, 25372-4, 25373-2, 34670-0, 45194-8, 55869-2, 55870-0, 56497-1, 80384-1, 80385-8, 83086-9, 93769-8, 99104-2 

Measure Codes

Chlamydia Screening Test

  • CPT: 87110, 87270, 87320, 87490, 87491, 97492, 87494, 87810
  • LOINC: 14463-4, 14464-2, 14465-9, 14467-5, 14474-1, 14513-6, 16600-9, 21190-4, 21191-2, 21613-5, 23838-6, 31775-0, 34710-4, 42931-6, 43304-5, 43404-3, 44806-8, 44807-6, 45068-4, 45069-2, 45072-6, 45073-4, 45075-9, 45084-1, 45089-0, 45090-8, 45091-6, 45093-2, 45095-7, 4993-2, 50387-0, 53925-4, 53926-2, 57287-5, 6353-7, 6356-0, 6357-8, 80360-1, 80361-9, 80362-7, 80363-5, 80364-3, 80365-0, 80367-6, 82306-2, 87949-4, 87950-2, 88221-7, 89648-0, 91860-7, 91873-0