Percentage of patients aged 18-75 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period
– DENOMINATOR
All patients aged 18-75 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period.
A qualifying visit in this case can include any of the following:
Annual Wellness Visit
Home Healthcare Services
Office Visit
Outpatient Consultation
Preventive Care Services Established Office Visit Up, 18 and Up
Preventive Care Services Initial Office Visit, 18 and Up
Telephone Visits
Numerator:
Patients who received a kidney health evaluation defined by an eGFR AND uACR within the measurement period.
Denominator Exclusions:
Patients with a diagnosis of End Stage Renal Disease (ESRD)
Patients with a diagnosis of Chronic Kidney Disease (CKD) Stage 5
Patients who have an order for or are receiving hospice or palliative care.
– APPLICATION WORKFLOW
For Denominator:
To record an encounter, navigate to Patient > Provider Notes > Create Superbill. Under the ‘Procedure-CPTs’, enter the relevant encounter code.
eSuperbill for Encounter
To document the diabetes diagnosis, use the workflow Patient > Provider Notes > Diagnoses. Here, click ‘Add’ and search for the relevant diagnosis. Fill out the details and once done, click ‘Save’.
Example of Diabetes Diagnosis
For Numerator:
Both the kidney health tests can be ordered via Patient > Provider Notes > Orders > Lab. Here, click ‘Add’, select a laboratory and search for the relevant laboratory procedure. Fill out the details and once done, click ‘Save & Accept’ or ‘Sign & Accept’.
Example of uACR Lab Test
For Denominator Exclusions:
To document the ESRD or Stage 5 CKD head over to Patient > Provider Note > Diagnoses. Here, click ‘Add’ and search for the relevant diagnosis. Fill out the details as needed and once done, click ‘Save’.
Example of Stage 5 CKD Diagnosis
For patients receiving palliative care during the measurement period:
To record the ‘Palliative Care Encounter’, head over to Patient > Provider Note > Evaluations.
Example of Palliative Care Encounter
To record the ‘Palliative Care Intervention’, use the workflow Patient > Provider Note > Evaluations.
Example of Palliative Care Intervention
To record the ‘Functional Assessment of Chronic Illness Therapy’ assessment, navigate to Patient > Provider Note > Evaluations.
Palliative Care Assessment
The “Encounter for palliative care” diagnosis can be recorded via Patient > Provider Note > Diagnoses.
‘Encounter for Palliative Care’ Diagnosis
To document that a patient is receiving hospice care outside of a hospital or long-term care facility, navigate to Patient > Provider Note > Evaluations. Use the below mentioned codes to order or perform an intervention:
385763009: Hospice Care (Regime/Therapy)
385765002: Hospice Care Management (Procedure)
Hospice Care Intervention
To document an inpatient encounter, navigate to Patient > Provider Note > Evaluations.
Example of Inpatient Encounter
To document a hospice care assessment, follow the workflow Patient > Provider Note > Evaluations. Click ‘Add’ and search for ‘Hospice Care [Minimum Data Set]’. Then select ‘Performed’ from the ‘Status’ dropdown and ‘Yes’ from the ‘Result’ field.
Hospice Care Assessment
A hospice encounter can be documented through Patient > Provider Note > Evaluations or Patient > Provider Note > Create Superbill.
