CMS134v8 – Diabetes: Medical Attention for Nephropathy

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 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.

For Denominator:

Patients 18-75 years of age with diabetes with a visit during the measurement period are included in denominator. To record diabetes, navigate to Patient > Clinical> Diagnosis

For Numerator:

Patients with a screening for nephropathy or evidence of nephropathy during the measurement period are included in the numerator of this measure. This includes patients who had one of the following:

• Patients with an active ARB or ACE inhibitor medication overlapping with the measurement period. (Patient>Clinical>Provider Note>Medication)
• Patients with a diagnosis of Hypertensive Chronic Kidney Disease, Kidney Failure, Glomerulonephritis and Nephrotic Syndrome, Diabetic Nephropathy or Proteinuria overlapping the measurement period. (Patient>Clinical>Provider Note>Diagnosis)
• Nephrology Screenings:
  • Patients with nephropathy screenings including the renal procedures such as kidney transplant, vascular access for dialysis or dialysis services. (Patient>Clinical>Provider Note> Procedures)
  • Patients with renal interventions for other services related to dialysis or dialysis education. (Patient>Clinical>Provider Note> Evaluations)
  • Patients with an encounter for ESRD monthly outpatient services.
  • Patients with urine protein laboratory tests performed with results that are not null. (Patient>Clinical>Provider Note> Orders & Results>Lab).

The LOINC code and description for a lab can be added through Settings>EHR>Laboratory>Codes.

-DENOMINATOR EXCLUSION:

Exclude patients who were in hospice care during the measurement year. Navigate to the evaluations tab to add evaluations Patient > Clinical > Evaluations.