Providers
Prenatal
Postpartum
Exclusions
General Questions
100

What does PA stand for?

What is a Physician Assistant 

100

Documentation that references the pregnancy or indicates the member is pregnant; examples include? (one or to answers = OK)

What is:  

  • Documentation in a standardized prenatal flow sheet
  • Documentation of last menstrual period (LMP), estimated date of delivery (EDD), or gestational age (GA)
  • Positive pregnancy test result
  • Documentation of gravidity and parity
  • Documentation of complete obstetrical history
  • Documentation of prenatal risk assessment and counseling/education
100

True or False: Notations of "not breastfeeding" are not acceptable as a breast evaluation for the assessment of weight, BP, breasts and abdomen component of postpartum care. 

What is True

100

How many exclusions are there for the PPC measure per the reference guide?

What is 5 

100

What pulls the member into the PPC Measure?

What is a Live Birth between 10/8/PY and 10/7MY

200

What does DEM stand for?

What is a Direct Entry Midwife

200

Evidence that a prenatal care procedure was performed; examples include: 1 or 2 answers are ok

What is 

  • Screening test in the form of an obstetric panel (must include all of the following: hematocrit, differential WBC count, platelet count, hepatitis B surface antigen, rubella antibody, syphilis test, RBC antibody screen, Rh and ABO blood typing)
  • TORCH antibody panel alone
  • Rubella antibody test/titer with an Rh incompatibility (ABO/Rh) blood typing
  • Ultrasound of a pregnant uterus
200

True or False: For the Postpartum visit you may use an Acute In-Patient Visit?

What is False

200

If you find documentation in the medical record states the member passed away is there a specific timeframe r/t to this exclusion; if so what is it?

What is MY = Measurement Year

200

What is Timeliness of prenatal care: The percentage of deliveries that received a prenatal care visit in the first trimester and.........

What is on or before the enrollment start date or within 42 days of enrollment in the organization 

300

What does CPM stand for?

What is a Certified Practice Midwife

300

The following notations or examples of documentation do not count as numerator compliant for PPC prenatal care (1 or 2 answers are ok)

What is: 

  • Pap test alone
  • Lab result alone
  • Ultrasound alone
  • Colposcopy alone (A colposcopy is a type of cervical cancer test that lets a doctor or nurse get a close-up look at the cervix, which is the opening to the uterus.)
  • Visit completed on the date of delivery
  • Visit with RN or nurse without appropriate provider signature
  • Evidence from a pregnancy summary document
300

The following notations or examples of documentation do not count as numerator compliant for PPC postpartum care: (1 or 2 answers are ok)

What is: 

  • Visit provided in an acute inpatient setting
  • Visit completed on the date of delivery
  • Colposcopy alone
  • Pap test alone
300

What is the timeframe associated with "Member did not have a live birth?

What is Anytime during Oct 8 PY to Oct 7 MY

300

What is postpartum care: The percentage of deliveries that had a postpartum visit on or between .......

What is  7 and 84 days after delivery 

400

What does NP stand for?

What is a Nurse Practitioner

400

You are reviewing the medical record and the header states Women's Health Document aka Pregnancy Summary document.  Can you accept any abstraction by our vendor from this specific record?

What is NO 

400

Member seen by their PPC (MD) for a PPV and was in timeframe upon review of the record it only mentions Depression Screening with a PHQ conducted.  Is this acceptable?

What is yes

400

What is the timeframe for Members who use hospice services or elect to use a hospice benefit?

What is anytime during the Measurement Year = MY 

400

Describes the total number of confirmed pregnancies and the births in a member's (obstetric/medical) history

What is Gravidity and parity (GP) 

500

What does IBCLC stand for?

What is an International Board Certified Lactation Consultant

500

You are reviewing the record and see an ED visit r/t pregnancy seen by a Resident Emergency Medicine Provider and Co-Signed by the OB/GYN provider who consulted during the visit.  Is this acceptable 

What is Yes 

500

You are reviewing the progress note from an MD/PCP and DOS is in timeframe; the only documentation states Member is bottle-feeding infant is this acceptable?

What is Yes - Infant Care 

500

Member had a LIVE Birth on 10-9-2025; is this an exclusion?

What is yes (out of timeframe) 

500

What does EDD stand for?

What is Estimated Date of Delivery