CMS 122v6: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Measure: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period
Measure TypeHigh Priority MeasureScoring
OutcomeYesA lower percentage indicates better quality
DenominatorPatients 18-75 years of age with diabetes with a visit during the measurement period
NumeratorPatients whose most recent HbA1c level (performed during the measurement period) is >9.0%
Denominator ExceptionsNone
Denominator ExclusionsExclude patients who were in hospice care during the measurement year

This eCQM requires a lab interface to be met. Customers interested in a lab interface should contact Sevocity Support to begin the process of a new interface setup. Interface setup requirements and fees vary per request.

Patients who meet the following criteria will be included in the denominator:

  • Age must be ≥ 18 years and < 75 years at the beginning of the Measurement Period

    AND

  • Must have an active diagnosis of Type 1 or Type 2 diabetes during the Measurement Period

    AND

  • Must have at least one encounter during the Measurement Period finalized by the EC/EP

CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99221, 99222, 99223, 99231, 99232, 99233, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285, 99305, 99306, 99307, 99308, 99309, 99310, 99251, 99252, 99253, 99254, 99255, 99381, 99382, 99383, 99384, 99024, 99391, 99392, 99393, 99394, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

HCPCS: G0402, G0438, G0439

The patient must have an active diagnosis of Type 1 or Type 2 diabetes during Measurement Period. Patients with a diagnosis of secondary diabetes due to another condition are not counted.

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for diabetes can be located here.

Patients who were in hospice care during the measurement year will be excluded from the measure.

To document hospice care services as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

SNOMED CT: 385763009, 385765002

Order Status must be marked as Complete.

SNOMED CT codes must be added as a Favorite in Preferences > Form Data > Orders to be accessible from the Orders/Referrals tab.

A patient will be counted in the numerator if they have an e-Lab result with an HbA1c level of > 9% stored to their chart during the Measurement Period. If there are multiple HbA1c results within the Measurement Period, the most recent result will be counted toward the numerator.

A patient will be included in the numerator if the most recent HbA1c result is missing or if there are no HbA1c tests performed and results documented during the Measurement Period.

  1. From the Clinic Inbox, select the lab result to be stored and click View
  2. Click Select to search for and select a patient
  3. Verify patient displayed matches the lab result and select the I have verified the following lab results belong to the above patient checkbox
  4. Click Sign/Route
  5. Select the Sign checkbox and click OK

Stored e-Lab results can be viewed in the Flowsheets/Labs > Scanned/E-Labs tab of the patient chart.

https://ecqi.healthit.gov/ecqm/ep/2018/cms122v6

 

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