NQF 0059: Diabetes: Hemoglobin A1c Poor Control

Measure: Record percentage of patients 18 - 75 years of age with Diabetes (type 1 or type 2) who had Hemoglobin A1c > 9.0% during the measurement period.
Numerator: Patients who meet the denominator criteria with the most recent documented HbA1c level (performed during the measurement period) greater than 9.0%.
Denominator: All patients 18-75 years of age with Diabetes (Type 1 or Type 2) and an encounter during the measurement period.
Exclusion:   Patients with a diagnosis of Gestational Diabetes during the measurement period.
NQS Domain: Clinical Process / Effectiveness

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient (age 18 to 75) at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator*:

• Office Visit or Face-to-Face Interaction (SNOMED) Code during the measurement period
Valid Office Visit Codes:
CPT: 
CodeDescription
99201Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99205Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99212Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99341Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99342Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99343Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99345Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent face-to-face with the patient and/or family.
99347Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99350Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99385Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99395Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older
G0438ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT
G0439ANNUAL WELLNESS VISIT, INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), SUBSEQUENT VISIT
Valid Face-to-Face Interaction Codes:
SNOMED: 
CodeDescription
4525004Emergency department patient visit (procedure)
12843005Subsequent hospital visit by physician (procedure)
18170008Subsequent nursing facility visit (procedure)
19681004Nursing evaluation of patient and report (procedure)
87790002Follow-up inpatient consultation visit (procedure)
90526000Initial evaluation and management of healthy individual (procedure)
185349003Encounter for "check-up" (procedure)
185463005Visit out of hours (procedure)
185465003Weekend visit (procedure)
207195004History and physical examination with evaluation and management of nursing facility patient (procedure)
270427003Patient-initiated encounter (procedure)
270430005Provider-initiated encounter (procedure)
308335008Patient encounter procedure (procedure)
390906007Follow-up encounter (procedure)
406547006Urgent follow-up (procedure)
439708006Home visit (procedure)
• Diabetes Diagnosis Code (with attached SNOMED) that starts before or during the measurement period and remains active throughout
ICD-9: 
CodeDescription
250.00Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
250.01Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled
250.02Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled
250.03Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled
250.10Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled
250.11Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled
250.12Diabetes with ketoacidosis, type II or unspecified type, uncontrolled
250.13Diabetes with ketoacidosis, type I [juvenile type], uncontrolled
250.20Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled
250.21Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled
250.22Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled
250.23Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled
250.30Diabetes with other coma, type II or unspecified type, not stated as uncontrolled
250.31Diabetes with other coma, type I [juvenile type], not stated as uncontrolled
250.32Diabetes with other coma, type II or unspecified type, uncontrolled
250.33Diabetes with other coma, type I [juvenile type], uncontrolled
250.41Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled
250.42Diabetes with renal manifestations, type II or unspecified type, uncontrolled
250.43Diabetes with renal manifestations, type I [juvenile type], uncontrolled
250.50Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled
250.51Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as uncontrolled
250.52Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled
250.53Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled
250.60Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled
250.61Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled
250.62Diabetes with neurological manifestations, type II or unspecified type, uncontrolled
250.63Diabetes with neurological manifestations, type I [juvenile type], uncontrolled
250.70Diabetes with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled
250.71Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled
250.72Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled
250.73Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled
250.80Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled
250.81Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled
250.82Diabetes with other specified manifestations, type II or unspecified type, uncontrolled
250.83Diabetes with other specified manifestations, type I [juvenile type], uncontrolled
250.90Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled
250.91Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled
250.92Diabetes with unspecified complication, type II or unspecified type, uncontrolled
250.93Diabetes with unspecified complication, type I [juvenile type], uncontrolled
648.01Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition
648.02Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication
648.03Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication
648.04Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication
ICD-10: 
CodeDescription
E10.10Type 1 diabetes mellitus with ketoacidosis without coma
E10.11Type 1 diabetes mellitus with ketoacidosis with coma
E10.21Type 1 diabetes mellitus with diabetic nephropathy
E10.22Type 1 diabetes mellitus with diabetic chronic kidney disease
E10.29Type 1 diabetes mellitus with other diabetic kidney complication
E10.311Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E10.321Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
E10.329Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
E10.331Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E10.339Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E10.341Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
E10.349Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E10.351Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema
E10.359Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema
E10.36Type 1 diabetes mellitus with diabetic cataract
E10.39Type 1 diabetes mellitus with other diabetic ophthalmic complication
E10.40Type 1 diabetes mellitus with diabetic neuropathy, unspecified
E10.41Type 1 diabetes mellitus with diabetic mononeuropathy
E10.42Type 1 diabetes mellitus with diabetic polyneuropathy
E10.43Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
E10.44Type 1 diabetes mellitus with diabetic amyotrophy
E10.49Type 1 diabetes mellitus with other diabetic neurological complication
E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E10.52Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.59Type 1 diabetes mellitus with other circulatory complications
E10.610Type 1 diabetes mellitus with diabetic neuropathic arthropathy
E10.618Type 1 diabetes mellitus with other diabetic arthropathy
E10.620Type 1 diabetes mellitus with diabetic dermatitis
E10.621Type 1 diabetes mellitus with foot ulcer
E10.622Type 1 diabetes mellitus with other skin ulcer
E10.628Type 1 diabetes mellitus with other skin complications
E10.630Type 1 diabetes mellitus with periodontal disease
E10.638Type 1 diabetes mellitus with other oral complications
E10.641Type 1 diabetes mellitus with hypoglycemia with coma
E10.649Type 1 diabetes mellitus with hypoglycemia without coma
E10.65Type 1 diabetes mellitus with hyperglycemia
E10.69Type 1 diabetes mellitus with other specified complication
E10.8Type 1 diabetes mellitus with unspecified complications
E10.9Type 1 diabetes mellitus without complications
E11.00Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E11.01Type 2 diabetes mellitus with hyperosmolarity with coma
E11.21Type 2 diabetes mellitus with diabetic nephropathy
E11.22Type 2 diabetes mellitus with diabetic chronic kidney disease
E11.29Type 2 diabetes mellitus with other diabetic kidney complication
E11.311Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.321Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
E11.329Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
E11.331Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E11.339Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E11.341Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
E11.349Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E11.351Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema
E11.359Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema
E11.36Type 2 diabetes mellitus with diabetic cataract
E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
E11.41Type 2 diabetes mellitus with diabetic mononeuropathy
E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
E11.43Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
E11.44Type 2 diabetes mellitus with diabetic amyotrophy
E11.49Type 2 diabetes mellitus with other diabetic neurological complication
E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E11.59Type 2 diabetes mellitus with other circulatory complications
E11.610Type 2 diabetes mellitus with diabetic neuropathic arthropathy
E11.618Type 2 diabetes mellitus with other diabetic arthropathy
E11.620Type 2 diabetes mellitus with diabetic dermatitis
E11.621Type 2 diabetes mellitus with foot ulcer
E11.622Type 2 diabetes mellitus with other skin ulcer
E11.628Type 2 diabetes mellitus with other skin complications
E11.630Type 2 diabetes mellitus with periodontal disease
E11.638Type 2 diabetes mellitus with other oral complications
E11.641Type 2 diabetes mellitus with hypoglycemia with coma
E11.649Type 2 diabetes mellitus with hypoglycemia without coma
E11.65Type 2 diabetes mellitus with hyperglycemia
E11.69Type 2 diabetes mellitus with other specified complication
E11.8Type 2 diabetes mellitus with unspecified complications
E11.9Type 2 diabetes mellitus without complications
O24.011Pre-existing diabetes mellitus, type 1, in pregnancy, first trimester
O24.012Pre-existing diabetes mellitus, type 1, in pregnancy, second trimester
O24.013Pre-existing diabetes mellitus, type 1, in pregnancy, third trimester
O24.019Pre-existing diabetes mellitus, type 1, in pregnancy, unspecified trimester
O24.02Pre-existing diabetes mellitus, type 1, in childbirth
O24.03Pre-existing diabetes mellitus, type 1, in the puerperium
O24.111Pre-existing diabetes mellitus, type 2, in pregnancy, first trimester
O24.112Pre-existing diabetes mellitus, type 2, in pregnancy, second trimester
O24.113Pre-existing diabetes mellitus, type 2, in pregnancy, third trimester
O24.119Pre-existing diabetes mellitus, type 2, in pregnancy, unspecified trimester
O24.12Pre-existing diabetes mellitus, type 2, in childbirth
O24.13Pre-existing diabetes mellitus, type 2, in the puerperium
SNOMED: 
CodeDescription
4783006Maternal diabetes mellitus with hypoglycemia affecting fetus OR newborn (disorder)
9859006Insulin-resistant diabetes mellitus AND acanthosis nigricans (disorder)
23045005Insulin dependent diabetes mellitus type IA (disorder)
28032008Insulin dependent diabetes mellitus type IB (disorder)
44054006Diabetes mellitus type 2 (disorder)
46635009Diabetes mellitus type 1 (disorder)
75682002Diabetes mellitus due to insulin receptor antibodies (disorder)
76751001Diabetes mellitus in mother complicating pregnancy, childbirth AND/OR puerperium (disorder)
81531005Diabetes mellitus type 2 in obese (disorder)
190330002Diabetes mellitus, juvenile type, with hyperosmolar coma (disorder)
190331003Diabetes mellitus, adult onset, with hyperosmolar coma (disorder)
190368000Type I diabetes mellitus with ulcer (disorder)
190369008Type I diabetes mellitus with gangrene (disorder)
190372001Type I diabetes mellitus maturity onset (disorder)
190389009Type II diabetes mellitus with ulcer (disorder)
190390000Type II diabetes mellitus with gangrene (disorder)
199223000Diabetes mellitus during pregnancy, childbirth and the puerperium (disorder)
199225007Diabetes mellitus during pregnancy - baby delivered (disorder)
199226008Diabetes mellitus in the puerperium - baby delivered during current episode of care (disorder)
199227004Diabetes mellitus during pregnancy - baby not yet delivered (disorder)
199228009Diabetes mellitus in the puerperium - baby delivered during previous episode of care (disorder)
199229001Pre-existing diabetes mellitus, insulin-dependent (disorder)
199230006Pre-existing diabetes mellitus, non-insulin-dependent (disorder)
237599002Insulin-treated non-insulin-dependent diabetes mellitus (disorder)
237618001Insulin-dependent diabetes mellitus secretory diarrhea syndrome (disorder)
237626009Pregnancy and insulin-dependent diabetes mellitus (disorder)
237627000Pregnancy and non-insulin-dependent diabetes mellitus (disorder)
313435000Type I diabetes mellitus without complication (disorder)
313436004Type II diabetes mellitus without complication (disorder)
314771006Type I diabetes mellitus with hypoglycemic coma (disorder)
314772004Type II diabetes mellitus with hypoglycemic coma (disorder)
314893005Type I diabetes mellitus with arthropathy (disorder)
314894004Type I diabetes mellitus with neuropathic arthropathy (disorder)
314902007Type II diabetes mellitus with peripheral angiopathy (disorder)
314903002Type II diabetes mellitus with arthropathy (disorder)
314904008Type II diabetes mellitus with neuropathic arthropathy (disorder)
359642000Diabetes mellitus type 2 in nonobese (disorder)
359939009Maternal diabetes mellitus (disorder)

Required Data Elements for the Numerator*:

• HbA1c Lab Result (LOINC) Code that occurs during the measurement period with an result of > 9% ( OR no occurrence of the code)
LOINC: 
CodeDescription
17855-8Hemoglobin A1c/Hemoglobin.total in Blood by calculation
17856-6Hemoglobin A1c/Hemoglobin.total in Blood by HPLC
4548-4Hemoglobin A1c/Hemoglobin.total in Blood

EXCLUSION DETAILS:

Exclusion includes patients with a diagnosis of Gestational Diabetes during the measurement period.  In order to meet the requirements for this exclusion the appropriate information must be documented in the chart:

• Gestational Diabetes Diagnosis Code (with attached SNOMED) that starts before or during (and does not end prior to the start of) the measurement period*
ICD-10: 
CodeDescription
O24.410Gestational diabetes mellitus in pregnancy, diet controlled
O24.414Gestational diabetes mellitus in pregnancy, insulin controlled
O24.419Gestational diabetes mellitus in pregnancy, unspecified control
O24.420Gestational diabetes mellitus in childbirth, diet controlled
O24.424Gestational diabetes mellitus in childbirth, insulin controlled
O24.429Gestational diabetes mellitus in childbirth, unspecified control
O24.430Gestational diabetes mellitus in the puerperium, diet controlled
O24.434Gestational diabetes mellitus in the puerperium, insulin controlled
O24.439Gestational diabetes mellitus in the puerperium, unspecified control
SNOMED: 
CodeDescription
11687002Gestational diabetes mellitus (disorder)
46894009Gestational diabetes mellitus, class A>2< (disorder)
71546005Gestational diabetes mellitus, class B>1< (disorder)
75022004Gestational diabetes mellitus, class A>1< (disorder)
420491007Gestational diabetes mellitus, class H (disorder)
420738003Gestational diabetes mellitus, class T (disorder)
420989005Gestational diabetes mellitus, class R (disorder)
421223006Gestational diabetes mellitus, class F (disorder)
421389009Gestational diabetes mellitus, class C (disorder)
421443003Gestational diabetes mellitus, class D (disorder)
422155003Gestational diabetes mellitus, class B (disorder)

*ADDITIONAL INFORMATION:

•  The patient must be age 18 years old and younger than 75 years of age prior to the start of the measurement period.

•  The HbA1c LOINC code can be linked to a corresponding electronic lab result condition or a numeric result template field.

•  The patient is numerator compliant if most recent HbA1c level >9% or is missing a result or if an HbA1c test was not done during the measurement year.

•  Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.

•  There are no valid ICD-9 codes for Gestational Diabetes, therefore a valid ICD-10 with an attached SNOMED code should be used instead.

•   The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes

 

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