CMS 123v6: Diabetes: Foot Exam

Measure: Percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
Measure TypeHigh Priority MeasureScoring
ProcessNoA higher percentage indicates better quality
DenominatorPatients 18-75 years of age with diabetes with a visit during the measurement period
NumeratorPatients who received visual, pulse and sensory foot examinations during the measurement period
Denominator ExceptionsNone
Denominator Exclusions

Patients who:

  • Have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period
  • Were in hospice care during the measurement year

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, 99231, 99232, 99233, 99234, 99235, 99236, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99318, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99221, 99222, 99223, 99251, 99252, 99253, 99254, 99255, 99381, 99382, 99383, 99384, 99024, 99391, 99392, 99393, 99394, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

HCPCS: 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 with an active diagnosis for a bilateral amputation above or below the knee or both a left and right amputation above or below the knee will be excluded from the measure.

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible amputation diagnosis codes can be located here. If documenting two unilateral amputations, the Anatomical Location Site must be specified when adding each diagnosis code.

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 received a diabetic foot exam during the Measurement Period.

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. Click Add New Flowsheet
  3. Select the Diabetes Care flowsheet and click Add
  4. Click Add Column
  5. Populate a Date and a Value for Diabetic Foot Exam
  6. Click OK to save

https://ecqi.healthit.gov/ecqm/ep/2018/cms123v6

 

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