Urinary
- 1090F - urinary incontinence assessed
- 0509F - urinary incontinence plan of care
- 1091F - urinary incontinence characterized
HEDIS Quality Codes
Search HEDIS quality codes by measure, category, or code.
Use this quick lookup for common CPT Category II and HCPCS quality codes used in Medicare Advantage, Medicaid managed care, and HEDIS gap-closure workflows.
Use Note
This is a working quality-code reference.
CPT Category II and HCPCS quality codes help communicate documented results or care actions to health plans. This page is not a licensed AMA CPT codebook and does not replace NCQA value sets, payer specifications, billing policy, or certified coding review.
- Search by code, measure, category, or plain-language use.
- Use the category buttons for common HEDIS gap workflows.
- Confirm final submission rules with the payer before billing or encounter submission.
Searchable Quality Code Table
66 common HEDIS CPT II and HCPCS quality codes.
Search examples: 1111F, G8417, BMI, statin, Plavix, urinary, blood pressure, A1c, eye exam.
BMI
- 3008F - BMI recorded
- G8417 - BMI above normal with follow-up plan
Cardiovascular
- 4013F - statin therapy
- 4086F - aspirin or clopidogrel/Plavix
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| Code | Category | Measure / Workflow | Plain-Language Use | Documentation Note |
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Key Example
1111F is for medication reconciliation after discharge.
For HEDIS transitions-of-care workflows, 1111F is commonly used when discharge medications have been reconciled with the current medication list in the outpatient medical record. The payer may require the reconciliation within a specific post-discharge time window and may require provider type, NPI, encounter, or documentation details.