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This variable indicates whether a beneficiary met the condition criteria for attention deficit hyperactivity disorder (ADHD) or other conduct disorders as of the end of the calendar year.
The condition variable requires beneficiaries to satisfy both claims criteria (a minimum number/type of Medicare claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (Medicare FFS Part A and Part B coverage during the entire specified time period).
For ADHD and other conduct disorders, beneficiaries must have at least one Medicare inpatient claim or two other non-drug claims of any service type with a related code in any position during the 2-year reference period. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories
For ADHD and other conduct disorders, beneficiaries must have at least one Medicare inpatient claim or two other non-drug claims of any service type with a related code in any position during the 2-year reference period. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories
| Code | Code value |
|---|---|
| 0 | Beneficiary did not meet claims criteria or have sufficient FFS coverage |
| 1 | Beneficiary met claims criteria but did not have sufficient FFS coverage |
| 2 | Beneficiary did not meet claims criteria but had sufficient FFS coverage |
| 3 | Beneficiary met claims criteria and had sufficient FFS coverage |