CMS122v13: Diabetes: Glycemic Status Assessment Greater Than >9%

Percentage of patients 18-75 years of age with diabetes who a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) > 9.0% during the measurement period *Telehealth Eligible*

This is an inverse measure. A lower score indicates better performance

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.

• Electronic Lab Results: An electronically received test name contains any of the following phrases and value >9.0%
  • Hemoglobin, A1C
  • Glycated Hemoglobin(Hgb A1C)
  • Hgb A1C Mean Bld Glucose
  • A1C
• Tracked Data: For those that do not receive test results electronically, the A1c or GMI result must be entered into the Tracked Data section of the patient’s:
  • From the patient’s chart, select “Summary Sheet” tab at the top of the chart
  • The “Tracked Data” section will be on the right of the page. Click “Add/Edit”
  • Enter either “A1c” or “GMI” into the Item
  • Enter the Value
  • Enter the date collected
  • Select “Move Data To Grid” and then click “Ok”
  • Select “Save and Close”

Denominator:

Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period

Exclusions:

• Exclude patients whose hospice or palliative care overlaps the measurement period:
  • Identified in the patient's Alerts and Directives, located in the demographic screen or the Summary Sheet, in the name, text or comments saved with that alert/directive. The Alert/Directive should include either of the following phrases:
    • palliative
    • hospice
• Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period:
  • Accomplished with adding the appropriate billing codes for Domiciliary or rest home visit for evaluation and management. The codes are 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
• Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
  • Advanced illness with one inpatient encounter during the measurement period or the year prior
    • Identified through a diagnosis in the chart. For a complete list of diagnosis, click HERE. Note: a diagnosis alone is not enough, the DX code must be added to the assessment and attached to the visit CPT code
• Or taking dementia medications during the measurement period or the year prior