CMS122v8 – Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)

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

– DENOMINATOR EXCLUSION:

Exclude patients whose hospice care overlaps the measurement period.

Exclude patients 66 and older who are living long term in an institution for more than 90 days during the measurement period.

Exclude patients 66 and older with advanced illness and frailty because it is unlikely that patients will benefit from the services being measured.

– NUMERATOR

Patients whose most recent HbA1c level (performed during the measurement period) is >9.0%

For Denominator:
The patient of age 18-75 with an active diagnosis of diabetes on the visit in the measurement year is considered for this measure. To record Diagnosis, navigate to Patient > Clinical > Diagnoses.

The system captures and calculates an encounter when a Visit code (E&M code) is documented in either eSuperbill or a charge. To record a visit code, navigate to Patient > Provider Notes > eSuperbill.

DENOMINATOR EXCLUSION:

To exclude patients who were in hospice care during the measurement year, navigate to Patient > Clinical > Evaluation. 

For Numerator:

Patients will be included in the numerator if any one of the following criteria is met:

• Has most recent HbA1c without result
• Has most recent elevated HbA1c
• Has no record of Hba1C

To record HbA1c level, navigate to Patient > Clinical > Orders and Results > Labs.

Moreover, if the patient record has multiple HbA1c records then the system will capture the value of the most recent result.