CMS 134v6: Diabetes: Medical Attention for Nephropathy

Measure: Percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
Measure Type High Priority Measure Scoring
Process No A higher percentage indicates better quality
Denominator Patients 18-75 years of age with diabetes with a visit during the measurement period
Numerator Patients with a screening for nephropathy or evidence of nephropathy during the measurement period
Denominator Exceptions None
Denominator Exclusions

Exclude patients who were in hospice care during the measurement year

A lab interface can be used to meet this eCQM but is not required. 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 received a screening for urine protein during the Measurement Period OR have evidence of nephropathy during the Measurement Period. Evidence of nephropathy qualifies as one or more of the following:

  • Active diagnosis of Hypertensive Chronic Kidney Disease, Kidney Failure, Glomerulonephritis and Nephrotic Syndrome, Diabetic Nephropathy, or Proteinuria
  • Active prescription for an ACE inhibitor or angiotensin-receptor blocker (ARB)
  • Kidney transplant, vascular access for dialysis, dialysis services, or end-stage renal disease (ESRD) monthly outpatient services performed
  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 Urine test for protein
  6. Click OK to save

  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.

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

To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > Prescribe a Medication. A comprehensive list of eligible ACE inhibitor and ARB medications can be located here.

To document a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below. Order Status must be marked as Complete in order to count toward the numerator.

Kidney Transplant

CPT: 50340, 50360, 50365, 50370, 50380

HCPCS: S2065

Vascular Access for Dialysis

CPT: 36147, 36148, 36800, 36810, 36815, 36818, 36819, 36820, 36821, 36831, 36832, 36833

Dialysis Services

CPT: 90920, 90921, 90924, 90925, 90935, 90937, 90940, 90945, 90947

HCPCS: G0257

ESRD Monthly Outpatient Services

CPT: 90957, 90958, 90959, 90960, 90961, 90962, 90965, 90966, 90969, 90970, 90989, 90993, 90997, 90999, 99512

https://ecqi.healthit.gov/ecqm/ep/2018/cms134v6

 

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