| eCQMs / NQF #: | CMS122v7 / 0059 |
| Measure: | Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period. |
| Numerator: | Patients whose most recent HbA1c level (performed during the measurement period) is >9.0%. |
| Denominator: | Patients 18-75 years of age with diabetes with a visit during the measurement period. |
| Exclusion: | Exclude patients who were in hospice care during the measurement year |
| Domain: | Effective Clinical Care |
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:
This is captured by adding a procedure with a valid CPT or SNOMED code using the Procedure widget in a note.
Valid Office Visit Codes:
| CPT: | |
| Code | Description |
| 99201 | Office 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. |
| 99202 | Office 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. |
| 99203 | Office 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. |
| 99204 | Office 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. |
| 99205 | Office 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. |
| 99212 | Office 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. |
| 99213 | Office 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. |
| 99214 | Office 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. |
| 99215 | Office 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. |
| 99341 | Home 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. |
| 99342 | Home 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. |
| 99343 | Home 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. |
| 99344 | Home 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. |
| 99345 | Home 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. |
| 99347 | Home 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. |
| 99348 | Home 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. |
| 99349 | Home 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. |
| 99350 | Home 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. |
| 99385 | Initial 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 |
| 99386 | Initial 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 |
| 99387 | Initial 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 |
| 99395 | Periodic 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 |
| 99396 | Periodic 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 |
| 99397 | Periodic 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 |
| G0438 | ANNUAL WELLNESS VISIT; INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), INITIAL VISIT |
| G0439 | ANNUAL WELLNESS VISIT, INCLUDES A PERSONALIZED PREVENTION PLAN OF SERVICE (PPS), SUBSEQUENT VISIT |
Valid Face-to-Face Interaction Codes:
| SNOMED: | |
| Code | Description |
| 4525004 | Emergency department patient visit (procedure) |
| 12843005 | Subsequent hospital visit by physician (procedure) |
| 18170008 | Subsequent nursing facility visit (procedure) |
| 19681004 | Nursing evaluation of patient and report (procedure) |
| 87790002 | Follow-up inpatient consultation visit (procedure) |
| 90526000 | Initial evaluation and management of healthy individual (procedure) |
| 185349003 | Encounter for "check-up" (procedure) |
| 185463005 | Visit out of hours (procedure) |
| 185465003 | Weekend visit (procedure) |
| 207195004 | History and physical examination with evaluation and management of nursing facility patient (procedure) |
| 270427003 | Patient-initiated encounter (procedure) |
| 270430005 | Provider-initiated encounter (procedure) |
| 308335008 | Patient encounter procedure (procedure) |
| 390906007 | Follow-up encounter (procedure) |
| 406547006 | Urgent follow-up (procedure) |
| 439708006 | Home visit (procedure) |
| 185460008 | Home visit request by patient (procedure) |
| 185462000 | Home visit request by relative (procedure) |
| 185466002 | Home visit for urgent condition (procedure) |
| 185467006 | Home visit for acute condition (procedure) |
| 185468001 | Home visit for chronic condition (procedure) |
| 185470005 | Home visit elderly assessment (procedure) |
| 225929007 | Joint home visit (procedure) |
| 315205008 | Bank holiday home visit (procedure) |
| 439708006 | Home visit (procedure) |
| 698704008 | Home visit for rheumatology service (procedure) |
| 704126008 | Home visit for anticoagulant drug monitoring (procedure) |
| 185463005 | Visit out of hours (procedure) |
| 185464004 | Out of hours visit - not night visit (procedure) |
| 185465003 | Weekend visit (procedure) |
| 30346009 | Evaluation and management of established outpatient in office or other outpatient facility (procedure) |
| 3391000175108 | Office visit for pediatric care and assessment (procedure) |
| 37894004 | Evaluation and management of new outpatient in office or other outpatient facility (procedure) |
| 439740005 | Postoperative follow-up visit (procedure) |
• Diabetes Diagnosis or SNOMED Code that starts before or during the measurement period and remains active throughout
Expand
This is captured by adding a diagnosis with a valid ICD10/ICD9 or SNOMED code using the Diagnosis widget in a note.
| ICD-9: | |
| Code | Description |
| 250.00 | Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled |
| 250.01 | Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled |
| 250.02 | Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled |
| 250.03 | Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled |
| 250.10 | Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled |
| 250.11 | Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled |
| 250.12 | Diabetes with ketoacidosis, type II or unspecified type, uncontrolled |
| 250.13 | Diabetes with ketoacidosis, type I [juvenile type], uncontrolled |
| 250.20 | Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled |
| 250.21 | Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled |
| 250.22 | Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled |
| 250.23 | Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled |
| 250.30 | Diabetes with other coma, type II or unspecified type, not stated as uncontrolled |
| 250.31 | Diabetes with other coma, type I [juvenile type], not stated as uncontrolled |
| 250.32 | Diabetes with other coma, type II or unspecified type, uncontrolled |
| 250.33 | Diabetes with other coma, type I [juvenile type], uncontrolled |
| 250.40 | Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.41 | Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.42 | Diabetes with renal manifestations, type II or unspecified type, uncontrolled |
| 250.43 | Diabetes with renal manifestations, type I [juvenile type], uncontrolled |
| 250.50 | Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.51 | Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.52 | Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled |
| 250.53 | Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled |
| 250.60 | Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.61 | Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.62 | Diabetes with neurological manifestations, type II or unspecified type, uncontrolled |
| 250.63 | Diabetes with neurological manifestations, type I [juvenile type], uncontrolled |
| 250.70 | Diabetes with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled |
| 250.71 | Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled |
| 250.72 | Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled |
| 250.73 | Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled |
| 250.80 | Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled |
| 250.81 | Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled |
| 250.82 | Diabetes with other specified manifestations, type II or unspecified type, uncontrolled |
| 250.83 | Diabetes with other specified manifestations, type I [juvenile type], uncontrolled |
| 250.90 | Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled |
| 250.91 | Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled |
| 250.92 | Diabetes with unspecified complication, type II or unspecified type, uncontrolled |
| 250.93 | Diabetes with unspecified complication, type I [juvenile type], uncontrolled |
| 357.2 | Polyneuropathy in diabetes |
| 362.01 | Background diabetic retinopathy |
| 362.02 | Proliferative diabetic retinopathy |
| 362.03 | Nonproliferative diabetic retinopathy NOS |
| 362.04 | Mild nonproliferative diabetic retinopathy |
| 362.05 | Moderate nonproliferative diabetic retinopathy |
| 362.06 | Severe nonproliferative diabetic retinopathy |
| 362.07 | Diabetic macular edema |
| 366.41 | Diabetic cataract |
| 648.00 | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable |
| 648.01 | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition |
| 648.02 | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication |
| 648.03 | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication |
| 648.04 | Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication |
| ICD-10: | |
| Code | Description |
| E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma |
| E10.11 | Type 1 diabetes mellitus with ketoacidosis with coma |
| E10.21 | Type 1 diabetes mellitus with diabetic nephropathy |
| E10.22 | Type 1 diabetes mellitus with diabetic chronic kidney disease |
| E10.29 | Type 1 diabetes mellitus with other diabetic kidney complication |
| E10.311 | Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E10.319 | Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E10.321 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema |
| E10.329 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema |
| E10.331 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema |
| E10.339 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema |
| E10.341 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema |
| E10.349 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema |
| E10.351 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| E10.359 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema |
| E10.36 | Type 1 diabetes mellitus with diabetic cataract |
| E10.39 | Type 1 diabetes mellitus with other diabetic ophthalmic complication |
| E10.40 | Type 1 diabetes mellitus with diabetic neuropathy, unspecified |
| E10.41 | Type 1 diabetes mellitus with diabetic mononeuropathy |
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy |
| E10.43 | Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E10.44 | Type 1 diabetes mellitus with diabetic amyotrophy |
| E10.49 | Type 1 diabetes mellitus with other diabetic neurological complication |
| E10.51 | Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene |
| E10.52 | Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E10.59 | Type 1 diabetes mellitus with other circulatory complications |
| E10.610 | Type 1 diabetes mellitus with diabetic neuropathic arthropathy |
| E10.618 | Type 1 diabetes mellitus with other diabetic arthropathy |
| E10.620 | Type 1 diabetes mellitus with diabetic dermatitis |
| E10.621 | Type 1 diabetes mellitus with foot ulcer |
| E10.622 | Type 1 diabetes mellitus with other skin ulcer |
| E10.628 | Type 1 diabetes mellitus with other skin complications |
| E10.630 | Type 1 diabetes mellitus with periodontal disease |
| E10.638 | Type 1 diabetes mellitus with other oral complications |
| E10.641 | Type 1 diabetes mellitus with hypoglycemia with coma |
| E10.649 | Type 1 diabetes mellitus with hypoglycemia without coma |
| E10.65 | Type 1 diabetes mellitus with hyperglycemia |
| E10.69 | Type 1 diabetes mellitus with other specified complication |
| E10.8 | Type 1 diabetes mellitus with unspecified complications |
| E10.9 | Type 1 diabetes mellitus without complications |
| E11.00 | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E11.01 | Type 2 diabetes mellitus with hyperosmolarity with coma |
| E11.21 | Type 2 diabetes mellitus with diabetic nephropathy |
| E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease |
| E11.29 | Type 2 diabetes mellitus with other diabetic kidney complication |
| E11.311 | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E11.319 | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E11.321 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema |
| E11.329 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema |
| E11.331 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema |
| E11.339 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema |
| E11.341 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema |
| E11.349 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema |
| E11.351 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| E11.359 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema |
| E11.36 | Type 2 diabetes mellitus with diabetic cataract |
| E11.39 | Type 2 diabetes mellitus with other diabetic ophthalmic complication |
| E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified |
| E11.41 | Type 2 diabetes mellitus with diabetic mononeuropathy |
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy |
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E11.44 | Type 2 diabetes mellitus with diabetic amyotrophy |
| E11.49 | Type 2 diabetes mellitus with other diabetic neurological complication |
| E11.51 | Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene |
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E11.59 | Type 2 diabetes mellitus with other circulatory complications |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy |
| E11.618 | Type 2 diabetes mellitus with other diabetic arthropathy |
| E11.620 | Type 2 diabetes mellitus with diabetic dermatitis |
| E11.621 | Type 2 diabetes mellitus with foot ulcer |
| E11.622 | Type 2 diabetes mellitus with other skin ulcer |
| E11.628 | Type 2 diabetes mellitus with other skin complications |
| E11.630 | Type 2 diabetes mellitus with periodontal disease |
| E11.638 | Type 2 diabetes mellitus with other oral complications |
| E11.641 | Type 2 diabetes mellitus with hypoglycemia with coma |
| E11.649 | Type 2 diabetes mellitus with hypoglycemia without coma |
| E11.65 | Type 2 diabetes mellitus with hyperglycemia |
| E11.69 | Type 2 diabetes mellitus with other specified complication |
| E11.8 | Type 2 diabetes mellitus with unspecified complications |
| E11.9 | Type 2 diabetes mellitus without complications |
| E13.00 | Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E13.01 | Other specified diabetes mellitus with hyperosmolarity with coma |
| E13.10 | Other specified diabetes mellitus with ketoacidosis without coma |
| E13.11 | Other specified diabetes mellitus with ketoacidosis with coma |
| E13.21 | Other specified diabetes mellitus with diabetic nephropathy |
| E13.22 | Other specified diabetes mellitus with diabetic chronic kidney disease |
| E13.29 | Other specified diabetes mellitus with other diabetic kidney complication |
| E13.311 | Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E13.319 | Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E13.321 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema |
| E13.329 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema |
| E13.331 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema |
| E13.339 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema |
| E13.341 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema |
| E13.349 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema |
| E13.351 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema |
| E13.359 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema |
| E13.36 | Other specified diabetes mellitus with diabetic cataract |
| E13.39 | Other specified diabetes mellitus with other diabetic ophthalmic complication |
| E13.40 | Other specified diabetes mellitus with diabetic neuropathy, unspecified |
| E13.41 | Other specified diabetes mellitus with diabetic mononeuropathy |
| E13.42 | Other specified diabetes mellitus with diabetic polyneuropathy |
| E13.43 | Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E13.44 | Other specified diabetes mellitus with diabetic amyotrophy |
| E13.49 | Other specified diabetes mellitus with other diabetic neurological complication |
| E13.51 | Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene |
| E13.52 | Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E13.59 | Other specified diabetes mellitus with other circulatory complications |
| E13.610 | Other specified diabetes mellitus with diabetic neuropathic arthropathy |
| E13.618 | Other specified diabetes mellitus with other diabetic arthropathy |
| E13.620 | Other specified diabetes mellitus with diabetic dermatitis |
| E13.621 | Other specified diabetes mellitus with foot ulcer |
| E13.622 | Other specified diabetes mellitus with other skin ulcer |
| E13.628 | Other specified diabetes mellitus with other skin complications |
| E13.630 | Other specified diabetes mellitus with periodontal disease |
| E13.638 | Other specified diabetes mellitus with other oral complications |
| E13.641 | Other specified diabetes mellitus with hypoglycemia with coma |
| E13.649 | Other specified diabetes mellitus with hypoglycemia without coma |
| E13.65 | Other specified diabetes mellitus with hyperglycemia |
| E13.69 | Other specified diabetes mellitus with other specified complication |
| E13.8 | Other specified diabetes mellitus with unspecified complications |
| E13.9 | Other specified diabetes mellitus without complications |
| O24.011 | Pre-existing diabetes mellitus, type 1, in pregnancy, first trimester |
| O24.012 | Pre-existing diabetes mellitus, type 1, in pregnancy, second trimester |
| O24.013 | Pre-existing diabetes mellitus, type 1, in pregnancy, third trimester |
| O24.019 | Pre-existing diabetes mellitus, type 1, in pregnancy, unspecified trimester |
| O24.02 | Pre-existing diabetes mellitus, type 1, in childbirth |
| O24.03 | Pre-existing diabetes mellitus, type 1, in the puerperium |
| O24.111 | Pre-existing diabetes mellitus, type 2, in pregnancy, first trimester |
| O24.112 | Pre-existing diabetes mellitus, type 2, in pregnancy, second trimester |
| O24.113 | Pre-existing diabetes mellitus, type 2, in pregnancy, third trimester |
| O24.119 | Pre-existing diabetes mellitus, type 2, in pregnancy, unspecified trimester |
| O24.12 | Pre-existing diabetes mellitus, type 2, in childbirth |
| O24.13 | Pre-existing diabetes mellitus, type 2, in the puerperium |
| O24.311 | Unspecified pre-existing diabetes mellitus in pregnancy, first trimester |
| O24.312 | Unspecified pre-existing diabetes mellitus in pregnancy, second trimester |
| O24.313 | Unspecified pre-existing diabetes mellitus in pregnancy, third trimester |
| O24.319 | Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester |
| O24.32 | Unspecified pre-existing diabetes mellitus in childbirth |
| O24.33 | Unspecified pre-existing diabetes mellitus in the puerperium |
| O24.811 | Other pre-existing diabetes mellitus in pregnancy, first trimester |
| O24.812 | Other pre-existing diabetes mellitus in pregnancy, second trimester |
| O24.813 | Other pre-existing diabetes mellitus in pregnancy, third trimester |
| O24.819 | Other pre-existing diabetes mellitus in pregnancy, unspecified trimester |
| O24.82 | Other pre-existing diabetes mellitus in childbirth |
| O24.83 | Other pre-existing diabetes mellitus in the puerperium |
| SNOMED: | |
| Code | Description |
| 105401000119101 | Diabetes mellitus due to pancreatic injury (disorder) |
| 106281000119103 | Pre-existing diabetes mellitus in mother complicating childbirth (disorder) |
| 10754881000119104 | Diabetes mellitus in mother complicating childbirth (disorder) |
| 111307005 | Leprechaunism syndrome (disorder) |
| 111552007 | Diabetes mellitus without complication (disorder) |
| 123763000 | Houssay's syndrome (disorder) |
| 127012008 | Lipoatrophic diabetes (disorder) |
| 1481000119100 | Diabetes mellitus type 2 without retinopathy (disorder) |
| 190330002 | Type 1 diabetes mellitus with hyperosmolar coma (disorder) |
| 190331003 | Type 2 diabetes mellitus with hyperosmolar coma (disorder) |
| 190368000 | Type I diabetes mellitus with ulcer (disorder) |
| 190369008 | Type I diabetes mellitus with gangrene (disorder) |
| 190372001 | Type I diabetes mellitus maturity onset (disorder) |
| 190389009 | Type II diabetes mellitus with ulcer (disorder) |
| 190390000 | Type II diabetes mellitus with gangrene (disorder) |
| 190406000 | Malnutrition-related diabetes mellitus with ketoacidosis (disorder) |
| 190407009 | Malnutrition-related diabetes mellitus with renal complications (disorder) |
| 190410002 | Malnutrition-related diabetes mellitus with peripheral circulatory complications (disorder) |
| 190411003 | Malnutrition-related diabetes mellitus with multiple complications (disorder) |
| 190412005 | Malnutrition-related diabetes mellitus without complications (disorder) |
| 199223000 | Diabetes mellitus during pregnancy, childbirth and the puerperium (disorder) |
| 199225007 | Diabetes mellitus during pregnancy - baby delivered (disorder) |
| 199226008 | Diabetes mellitus in the puerperium - baby delivered during current episode of care (disorder) |
| 199227004 | Diabetes mellitus during pregnancy - baby not yet delivered (disorder) |
| 199228009 | Diabetes mellitus in the puerperium - baby delivered during previous episode of care (disorder) |
| 199229001 | Pre-existing type 1 diabetes mellitus (disorder) |
| 199230006 | Pre-existing type 2 diabetes mellitus (disorder) |
| 199231005 | Pre-existing malnutrition-related diabetes mellitus (disorder) |
| 23045005 | Insulin dependent diabetes mellitus type IA (disorder) |
| 237599002 | Insulin treated type 2 diabetes mellitus (disorder) |
| 237600004 | Malnutrition-related diabetes mellitus - fibrocalculous (disorder) |
| 237601000 | Secondary endocrine diabetes mellitus (disorder) |
| 237604008 | Maturity onset diabetes of the young, type 2 (disorder) |
| 237613005 | Hyperproinsulinemia (disorder) |
| 237618001 | Insulin-dependent diabetes mellitus secretory diarrhea syndrome (disorder) |
| 237619009 | Diabetes-deafness syndrome maternally transmitted (disorder) |
| 237627000 | Pregnancy and type 2 diabetes mellitus (disorder) |
| 237651005 | Insulin resistance - type A (disorder) |
| 24203005 | Extreme insulin resistance with acanthosis nigricans, hirsutism AND abnormal insulin receptors (disorder) |
| 2751001 | Fibrocalculous pancreatic diabetes (disorder) |
| 28032008 | Insulin dependent diabetes mellitus type IB (disorder) |
| 31321000119102 | Diabetes mellitus type 1 without retinopathy (disorder) |
| 313435000 | Type I diabetes mellitus without complication (disorder) |
| 313436004 | Type II diabetes mellitus without complication (disorder) |
| 314771006 | Type I diabetes mellitus with hypoglycemic coma (disorder) |
| 314772004 | Type II diabetes mellitus with hypoglycemic coma (disorder) |
| 314893005 | Type I diabetes mellitus with arthropathy (disorder) |
| 314894004 | Type I diabetes mellitus with neuropathic arthropathy (disorder) |
| 314902007 | Type II diabetes mellitus with peripheral angiopathy (disorder) |
| 314903002 | Type II diabetes mellitus with arthropathy (disorder) |
| 314904008 | Type II diabetes mellitus with neuropathic arthropathy (disorder) |
| 33559001 | Pineal hyperplasia AND diabetes mellitus syndrome (disorder) |
| 359642000 | Diabetes mellitus type 2 in nonobese (disorder) |
| 368521000119107 | Disorder of nerve co-occurrent and due to type 1 diabetes mellitus (disorder) |
| 408539000 | Insulin autoimmune syndrome (disorder) |
| 426705001 | Diabetes mellitus co-occurrent and due to cystic fibrosis (disorder) |
| 426875007 | Latent autoimmune diabetes mellitus in adult (disorder) |
| 427089005 | Diabetes mellitus due to cystic fibrosis (disorder) |
| 42954008 | Diabetes mellitus associated with receptor abnormality (disorder) |
| 44054006 | Diabetes mellitus type 2 (disorder) |
| 445260006 | Posttransplant diabetes mellitus (disorder) |
| 446641003 | Renal cysts and diabetes syndrome (disorder) |
| 46635009 | Diabetes mellitus type 1 (disorder) |
| 4783006 | Maternal diabetes mellitus with hypoglycemia affecting fetus OR newborn (disorder) |
| 51002006 | Diabetes mellitus associated with pancreatic disease (disorder) |
| 530558861000132104 | Atypical diabetes mellitus (disorder) |
| 57886004 | Protein-deficient diabetes mellitus (disorder) |
| 59079001 | Diabetes mellitus associated with hormonal etiology (disorder) |
| 5969009 | Diabetes mellitus associated with genetic syndrome (disorder) |
| 609561005 | Maturity-onset diabetes of the young (disorder) |
| 609562003 | Maturity onset diabetes of the young, type 1 (disorder) |
| 609563008 | Pre-existing diabetes mellitus in pregnancy (disorder) |
| 609564002 | Pre-existing type 1 diabetes mellitus in pregnancy (disorder) |
| 609566000 | Pregnancy and type 1 diabetes mellitus (disorder) |
| 609567009 | Pre-existing type 2 diabetes mellitus in pregnancy (disorder) |
| 609568004 | Diabetes mellitus due to genetic defect in beta cell function (disorder) |
| 609569007 | Diabetes mellitus due to genetic defect in insulin action (disorder) |
| 609570008 | Maturity-onset diabetes of the young, type 3 (disorder) |
| 609571007 | Maturity-onset diabetes of the young, type 4 (disorder) |
| 609572000 | Maturity-onset diabetes of the young, type 5 (disorder) |
| 609573005 | Maturity-onset diabetes of the young, type 6 (disorder) |
| 609574004 | Maturity-onset diabetes of the young, type 7 (disorder) |
| 609575003 | Maturity-onset diabetes of the young, type 8 (disorder) |
| 609576002 | Maturity-onset diabetes of the young, type 9 (disorder) |
| 609577006 | Maturity-onset diabetes of the young, type 10 (disorder) |
| 609578001 | Maturity-onset diabetes of the young, type 11 (disorder) |
| 70694009 | Diabetes mellitus AND insipidus with optic atrophy AND deafness (disorder) |
| 709147009 | Gingivitis co-occurrent with diabetes mellitus (disorder) |
| 710815001 | Long-term current use of insulin (situation) |
| 716362006 | Gingival disease co-occurrent with diabetes mellitus (disorder) |
| 71791000119104 | Peripheral neuropathy co-occurrent and due to type 1 diabetes mellitus (disorder) |
| 719216001 | Hypoglycemic coma co-occurrent and due to diabetes mellitus type II (disorder) |
| 720519003 | Atherosclerosis, deafness, diabetes, epilepsy, nephropathy syndrome (disorder) |
| 722454003 | Intellectual disability, craniofacial dysmorphism, hypogonadism, diabetes mellitus syndrome (disorder) |
| 724136006 | Diabetic mastopathy (disorder) |
| 724205009 | Laminopathy type Decaudain Vigouroux (disorder) |
| 724810001 | Radiculoplexoneuropathy due to diabetes mellitus (disorder) |
| 724997001 | Lumbosacral plexopathy co-occurrent and due to diabetes mellitus (disorder) |
| 73211009 | Diabetes mellitus (disorder) |
| 733072002 | Alaninuria, microcephaly, dwarfism, enamel hypoplasia, diabetes mellitus syndrome (disorder) |
| 734022008 | Wolfram-like syndrome (disorder) |
| 75524006 | Malnutrition related diabetes mellitus (disorder) |
| 75682002 | Diabetes mellitus caused by insulin receptor antibodies (disorder) |
| 76751001 | Diabetes mellitus in mother complicating pregnancy, childbirth AND/OR puerperium (disorder) |
| 81531005 | Diabetes mellitus type 2 in obese (disorder) |
| 8801005 | Secondary diabetes mellitus (disorder) |
| 91352004 | Diabetes mellitus due to structurally abnormal insulin (disorder) |
| 9859006 | Type 2 diabetes mellitus with acanthosis nigricans (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)
Expand
If a HbA1c laboratory test was performed, it can be captured by:
• An electronic lab result with a valid LOINC code,
• Adding a numeric result with a valid LOINC code using a numeric control in a note,
or
• Adding a procedure with a valid LOINC code using the Procedure widget in a note
| LOINC: | |
| Code | Description |
| 17855-8 | Hemoglobin A1c/Hemoglobin.total in Blood by calculation |
| 17856-6 | Hemoglobin A1c/Hemoglobin.total in Blood by HPLC |
| 4548-4 | Hemoglobin A1c/Hemoglobin.total in Blood |
Denominator Exclusion:
To document this one of the following must be taken:
Option 1: Inpatient Code and Hospice Discharge Code documented together
Inpatient Encounter Code
- 183452005: Emergency hospital admission (procedure)
- 32485007: Hospital admission (procedure)
- 8715000: Hospital admission, elective (procedure)
AND
Hospice Care Discharge Status SNOMED (one of the following):
- 428371000124100: Discharged to Health Care Facility for Hospice Care
- 428361000124107: Discharged to Home for Hospice Care
Option #2 - Hospice care ambulatory code ORDERED and PERFORMED:
Intervention, Order and Performed: Hospice care ambulatory
-
385763009: Hospice care (regime/therapy)
-
385765002: Hospice care management (procedure)
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%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period.
• 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.
• 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