NQF 0060: Hemoglobin A1c Test for Pediatric Patients

Measure: Record the percentage of patients 5-17 years of age with diabetes with an HbA1c test during the measurement period.
Numerator: Patients in the denominator with documentation of date and result for a HbA1c test during the measurement period.
Denominator: Patients 5 to 17 years of age with a diagnosis of diabetes and a face-to-face visit between the physician and the patient that predates the most recent visit by at least 12 months.
Exclusion: None
NQS Domain: Clinical Process\Effectiveness

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, age 5-17 years, at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator*:

• Diabetes Encounter Code (CPT or SNOMED) 12 months or more prior to the beginning of the measurement period
CPT: 
CodeDescription
92002Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
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.
99217Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])
99218Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission to "observation status" are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
99219Initial observation care, per day, for the evaluation and management of a 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 problem(s) requiring admission to "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99220Initial observation care, per day, for the evaluation and management of a 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 problem(s) requiring admission to "observation status" are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99221Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
99222Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99231Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or 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 patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99232Subsequent hospital care, per day, for the evaluation and management of a 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 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 patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99233Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed 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 patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99238Hospital discharge day management; 30 minutes or less
99239Hospital discharge day management; more than 30 minutes
99241Office consultation for a new or established 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 self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99242Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded 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, 30 minutes are spent face-to-face with the patient and/or family.
99243Office consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed 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, 40 minutes are spent face-to-face with the patient and/or family.
99244Office consultation for a new or established 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 moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99245Office consultation for a new or established 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 presenting problem(s) are of moderate to high severity. Typically, 80 minutes are spent face-to-face with the patient and/or family.
99251Inpatient consultation for a new or established 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 self limited or minor. Typically, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.
99252Inpatient consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded 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, 40 minutes are spent at the bedside and on the patient's hospital floor or unit.
99253Inpatient consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed 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, 55 minutes are spent at the bedside and on the patient's hospital floor or unit.
99254Inpatient consultation for a new or established 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 moderate to high severity. Typically, 80 minutes are spent at the bedside and on the patient's hospital floor or unit.
99255Inpatient consultation for a new or established 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 presenting problem(s) are of moderate to high severity. Typically, 110 minutes are spent at the bedside and on the patient's hospital floor or unit.
99281Emergency department visit for the evaluation and management of a 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 self limited or minor.
99282Emergency department visit for the evaluation and management of a 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 low to moderate severity.
99283Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused 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 severity.
99284Emergency department visit for the evaluation and management of a 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 high severity, and require urgent evaluation by the physician physicians, or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function.
99285Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: 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 presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.
99291Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
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.
99381Initial 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; infant (age younger than 1 year)
99382Initial 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; early childhood (age 1 through 4 years)
99383Initial 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; late childhood (age 5 through 11 years)
99384Initial 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; adolescent (age 12 through 17 years)
99391Periodic 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; infant (age younger than 1 year)
99392Periodic 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; early childhood (age 1 through 4 years)
99393Periodic 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; late childhood (age 5 through 11 years)
99394Periodic 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; adolescent (age 12 through 17 years)
99401Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
99402Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes
99403Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes
99404Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes
99420Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal)
99429Unlisted preventive medicine service
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)
25434003Limited eye examination (procedure)
36228007Ophthalmic examination and evaluation (procedure)
66902005Ophthalmic examination and evaluation, follow-up (procedure)
78831002Comprehensive eye examination (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)
225687009Observing eye during eye care (procedure)
252833009Extended tonometry (procedure)
252835002Extended tonometry - office hours (procedure)
252836001Extended tonometry - 24 hours (procedure)
268360001Visual testing (procedure)
270427003Patient-initiated encounter (procedure)
270430005Provider-initiated encounter (procedure)
308335008Patient encounter procedure (procedure)
390906007Follow-up encounter (procedure)
397532009Visual field examination for driving (procedure)
397533004Eye examination for driving (procedure)
406547006Urgent follow-up (procedure)
439708006Home visit (procedure)
• Diabetes Encounter Code (CPT or SNOMED) during the measurement period
CPT: 
CodeDescription
92002Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
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.
99217Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])
99218Initial observation care, per day, for the evaluation and management of a patient which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission to "observation status" are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
99219Initial observation care, per day, for the evaluation and management of a 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 problem(s) requiring admission to "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99220Initial observation care, per day, for the evaluation and management of a 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 problem(s) requiring admission to "observation status" are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99221Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit.
99222Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
99231Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or 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 patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
99232Subsequent hospital care, per day, for the evaluation and management of a 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 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 patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
99233Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed 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 patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99238Hospital discharge day management; 30 minutes or less
99239Hospital discharge day management; more than 30 minutes
99241Office consultation for a new or established 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 self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99242Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded 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, 30 minutes are spent face-to-face with the patient and/or family.
99243Office consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed 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, 40 minutes are spent face-to-face with the patient and/or family.
99244Office consultation for a new or established 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 moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99245Office consultation for a new or established 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 presenting problem(s) are of moderate to high severity. Typically, 80 minutes are spent face-to-face with the patient and/or family.
99251Inpatient consultation for a new or established 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 self limited or minor. Typically, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.
99252Inpatient consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded 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, 40 minutes are spent at the bedside and on the patient's hospital floor or unit.
99253Inpatient consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed 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, 55 minutes are spent at the bedside and on the patient's hospital floor or unit.
99254Inpatient consultation for a new or established 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 moderate to high severity. Typically, 80 minutes are spent at the bedside and on the patient's hospital floor or unit.
99255Inpatient consultation for a new or established 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 presenting problem(s) are of moderate to high severity. Typically, 110 minutes are spent at the bedside and on the patient's hospital floor or unit.
99281Emergency department visit for the evaluation and management of a 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 self limited or minor.
99282Emergency department visit for the evaluation and management of a 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 low to moderate severity.
99283Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused 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 severity.
99284Emergency department visit for the evaluation and management of a 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 high severity, and require urgent evaluation by the physician physicians, or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function.
99285Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: 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 presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.
99291Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
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.
99381Initial 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; infant (age younger than 1 year)
99382Initial 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; early childhood (age 1 through 4 years)
99383Initial 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; late childhood (age 5 through 11 years)
99384Initial 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; adolescent (age 12 through 17 years)
99391Periodic 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; infant (age younger than 1 year)
99392Periodic 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; early childhood (age 1 through 4 years)
99393Periodic 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; late childhood (age 5 through 11 years)
99394Periodic 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; adolescent (age 12 through 17 years)
99401Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
99402Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes
99403Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes
99404Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes
99420Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal)
99429Unlisted preventive medicine service
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)
25434003Limited eye examination (procedure)
36228007Ophthalmic examination and evaluation (procedure)
66902005Ophthalmic examination and evaluation, follow-up (procedure)
78831002Comprehensive eye examination (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)
225687009Observing eye during eye care (procedure)
252833009Extended tonometry (procedure)
252835002Extended tonometry - office hours (procedure)
252836001Extended tonometry - 24 hours (procedure)
268360001Visual testing (procedure)
270427003Patient-initiated encounter (procedure)
270430005Provider-initiated encounter (procedure)
308335008Patient encounter procedure (procedure)
390906007Follow-up encounter (procedure)
397532009Visual field examination for driving (procedure)
397533004Eye examination for driving (procedure)
406547006Urgent follow-up (procedure)
439708006Home visit (procedure)
• Diabetes Diagnosis Code (with attached SNOMED) that starts prior to or during the most recent Diabetes encounter during the measurement period
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
E13.00Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E13.01Other specified diabetes mellitus with hyperosmolarity with coma
E13.10Other specified diabetes mellitus with ketoacidosis without coma
E13.11Other specified diabetes mellitus with ketoacidosis with coma
E13.21Other specified diabetes mellitus with diabetic nephropathy
E13.22Other specified diabetes mellitus with diabetic chronic kidney disease
E13.29Other specified diabetes mellitus with other diabetic kidney complication
E13.311Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.321Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema
E13.329Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema
E13.331Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema
E13.339Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema
E13.341Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema
E13.349Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema
E13.351Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema
E13.359Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema
E13.36Other specified diabetes mellitus with diabetic cataract
E13.39Other specified diabetes mellitus with other diabetic ophthalmic complication
E13.40Other specified diabetes mellitus with diabetic neuropathy, unspecified
E13.41Other specified diabetes mellitus with diabetic mononeuropathy
E13.42Other specified diabetes mellitus with diabetic polyneuropathy
E13.43Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
E13.44Other specified diabetes mellitus with diabetic amyotrophy
E13.49Other specified diabetes mellitus with other diabetic neurological complication
E13.51Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene
E13.52Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
E13.59Other specified diabetes mellitus with other circulatory complications
E13.610Other specified diabetes mellitus with diabetic neuropathic arthropathy
E13.618Other specified diabetes mellitus with other diabetic arthropathy
E13.620Other specified diabetes mellitus with diabetic dermatitis
E13.621Other specified diabetes mellitus with foot ulcer
E13.622Other specified diabetes mellitus with other skin ulcer
E13.628Other specified diabetes mellitus with other skin complications
E13.630Other specified diabetes mellitus with periodontal disease
E13.638Other specified diabetes mellitus with other oral complications
E13.641Other specified diabetes mellitus with hypoglycemia with coma
E13.649Other specified diabetes mellitus with hypoglycemia without coma
E13.65Other specified diabetes mellitus with hyperglycemia
E13.69Other specified diabetes mellitus with other specified complication
E13.8Other specified diabetes mellitus with unspecified complications
E13.9Other specified 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
O24.311Unspecified pre-existing diabetes mellitus in pregnancy, first trimester
O24.312Unspecified pre-existing diabetes mellitus in pregnancy, second trimester
O24.313Unspecified pre-existing diabetes mellitus in pregnancy, third trimester
O24.319Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester
O24.32Unspecified pre-existing diabetes mellitus in childbirth
O24.33Unspecified pre-existing diabetes mellitus in the puerperium
O24.811Other pre-existing diabetes mellitus in pregnancy, first trimester
O24.812Other pre-existing diabetes mellitus in pregnancy, second trimester
O24.813Other pre-existing diabetes mellitus in pregnancy, third trimester
O24.819Other pre-existing diabetes mellitus in pregnancy, unspecified trimester
O24.82Other pre-existing diabetes mellitus in childbirth
O24.83Other pre-existing diabetes mellitus in the puerperium
SNOMED:  
CodeDescription
4783006Maternal diabetes mellitus with hypoglycemia affecting fetus OR newborn (disorder)
9859006Type 2 diabetes mellitus with 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)
190330002Type 1 diabetes mellitus with hyperosmolar coma (disorder)
190331003Type 2 diabetes mellitus 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 type 1 diabetes mellitus (disorder)
199230006Pre-existing type 2 diabetes mellitus (disorder)
237599002Insulin treated type 2 diabetes mellitus (disorder)
237618001Insulin-dependent diabetes mellitus secretory diarrhea syndrome (disorder)
237627000Pregnancy and type 2 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)

Required Data Elements for the Numerator*:

• HbA1c Result (with attached LOINC Code) during the measurement period
LOINC:  
CodeDescription
17856-6Hemoglobin A1c/Hemoglobin.total in Blood by HPLC
4548-4Hemoglobin A1c/Hemoglobin.total in Blood
4549-2Hemoglobin A1c/Hemoglobin.total in Blood by Electrophoresis
*ADDITIONAL INFORMATION:

•  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.

•  The HbA1c LOINC code can be linked to a result from an electronic interface or to a numeric field where a result in manually entered via a note.

•  Any condition being indicated as a result with an attached LOINC code MUST be marked as a result in the properties of that condition.  A condition should NOT be marked as both a result and an order (tracking)

•  The patient must be between the ages of 5 and 17 prior to the start of the measurement period.

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