Measure: Percentage of patients 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) > 9.0% during the measurement period | ||
| Measure Type | High Priority Measure | Scoring |
| Outcome | Yes | A lower percentage indicates better quality |
| Denominator | Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period |
| Numerator | Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is >9.0% or is missing, or was not performed during the measurement period |
| Denominator Exceptions | None |
| Denominator Exclusions |
|
Setup Note
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.
Denominator
Patients who meet the following criteria will be included in the denominator:
Age is 18 years to 75 years at the end of the Measurement Period
AND
Have an active diagnosis of Type 1 or Type 2 diabetes during the Measurement Period
AND
- Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator
CPT: 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99395, 99396, 99397, 99385, 99386, 99387, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 97802, 97803, 97804, 97804, 97802, 97803, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98966, 98967, 98968, 99441, 99442, 99443
HCPCS: G0402, G0438, G0439, G0270, G0271, G0447, S9449, S9452, S9470
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for diabetes can be located here.
Denominator Exclusions
A patient will be excluded from this measure if they meet any of the following conditions:
- Is in hospice care for any part of the Measurement Period
- Is receiving palliative care for any part of the Measurement Period
- Age is ≥ 66 at the end of the Measurement Period and are living long term in a nursing home any time on or before the end of the Measurement Period
- Age is ≥ 66 at the end of the Measurement Period and has evidence of frailty and advanced illness
Hospice Care Services
To document hospice care ambulatory services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
CPT: 99377, 99378
HCPCS: G0182
Order Status must be marked as Pending or Complete.
To document hospice care encounter services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9473, G9474, G9475, G9476, G9477, G9478, G9479, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5010, S9126, T2042, T2043, T2044, T2045, T2046
Order Status must be marked as Complete.
Palliative Care
Palliative care services can be documented using the FACIT-Pal Questionnaire flowsheet, as an order, or as a diagnosis.
FACIT-Pal Questionnaire Flowsheet
Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
Click Add New Flowsheet
Select the FACIT-Pal Questionnaire flowsheet and click Add
Click Add Column
Populate the patient’s responses to the questions as appropriate
Click OK to save
Palliative Care Services Order
Go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9054
Order Status must be marked as Complete.
Palliative Care Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis code for palliative care is:
ICD-10: Z51.5
Living Long Term in a Nursing Home
To document a nursing home stay:
Go to Chart > Demographics > Patient Info
Click Update
Click Additional Info tab
Populate the Date field in the Pop. Info section
Select Patient lives in nursing home for Housing Status
Click Save
Frailty and Advanced Illness
Frailty
A patient has evidence of frailty if they meet any of the following criteria:
- Has an active diagnosis of Frailty during the Measurement Period
- Has an active diagnosis of Frailty Symptom during the Measurement Period
- Is using a frailty device during the Measurement Period
- Has a frailty encounter during the Measurement Period
Frailty Diagnosis
“Frailty” refers to a range of conditions that includes falls and problems affecting mobility.
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for frailty can be located here.
Frailty Symptom Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for frailty symptoms are:
ICD-10: R26.2, R26.89, R26.9, R53.1, R53.81, R54, R62.7, R63.4, R63.6, R64
Frailty Device Use
To document the patient’s use of a frailty device:
- Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
- Click Add New Flowsheet
- Select the Frailty Device flowsheet and click Add
- Click Add Column
- Select a Device and the type (Value) of device
- Populate a usage Start Date for the device
- Optional: populate a usage Stop Date for the device
- The Stop Date cannot occur prior to the start of the Measurement Period
- Optional: populate a Reason for use of the device
- Click OK to save
Frailty Encounter Codes Eligible for Denominator Exclusion
CPT: 99504, 99509
HCPCS: G0162, G0299, G0300, G0493, G0494, S0271, S0311, S9123, S9124, T1000, T1001, T1002, T1003, T1004, T1005, T1019, T1020, T1021, T1022, T1030, T1031
Advanced Illness
A patient has evidence of advanced illness if they meet any of the following criteria:
- Had an active diagnosis of Advanced Illness during the Measurement Period or in the year prior
- Was prescribed medication for dementia during the Measurement Period or in the year prior
Advanced Illness Diagnosis
“Advanced illness” refers to a wide range of conditions and includes diseases such as Alzheimer’s disease, cancer, and heart failure.
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for advanced illness can be located here.
Medication
To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription or Chart > Medications/Assessments > Modify. A comprehensive list of eligible dementia medications can be located here.
Numerator
A patient will be counted in the numerator if they have an e-Lab result with a glycemic status assessment (HbA1c or GMI) greater than 9% stored to their chart during the Measurement Period. A patient will be also be counted in the numerator if the most recent glycemic status assessment result is missing or if there are no glycemic status assessments performed and no results documented during the Measurement Period.
Note
If there are multiple glycemic status assessment results within the Measurement Period, the lowest result will be counted toward the numerator.
Store e-Lab Result
- From the Clinic Inbox, select the lab result to be stored and click View
- If the lab result is systematically matched to a patient, the Patient section will be populated in the lab result display
- If the lab result is not matched or the matched patient needs to be changed, the user will need to search for the patient
- Optional: click Select to search for and select a patient
- Select the I have verified the following lab results belong to the above patient checkbox
- Click Sign/Route
- 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.
eCQI Reference
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