NQF 0059/PQRI 1 (Additional) - Diabetes: Hemoglobin A1c Poor Control

Measure: NQF 0059 (Additional Measurement)

Measure: Diabetes: HbA1c Poor Control

Measure Description: The percentage of patients 18–75 years of age with diabetes (type 1 or type 2) who had HbA1c >9.0%.

*REQUIRED FOR MEANINGFUL USE (MU) CORE REQUIREMENT - Click here to view Meaningful Use Criteria.

Quality Measure Documentation Workflow

1.  The patient must be between the ages of 17 and 74 years old at the start of the reporting period and have at least one face-to-face encounter with the provider during the reporting period.

2.  A diagnosis of Diabetes (recorded by using any of the ICD9 codes listed below) must be recorded in the patient's Summary Active Problems field OR encounter Assessment field.

250, 250.0, 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.4, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.7, 250.70, 250.71, 250.72, 250.73, 250.8, 250.80, 250.81, 250.82, 250.83, 250.9, 250.90, 250.91, 250.92, 250.93, 357.2, 362.0, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06, 362.07, 366.41, 648.0, 648.00, 648.01, 648.02, 648.03, 648.04

3.  In addition, there should be documentation to record patients that had HbA1c >9.0%.  This can be documented by inserting the shortcut code "PQRIdmA1c" in the encounter Plan field or Summary Interventions field will allow the user to select from a group of specific SMARText item codes that can be used to document for this measure.  If the patient had a HbA1c >9.0%, the encounter Plan field or Summary Interventions field must include the following code: 3046F.

Measurement Calculation Details

Numerator Calculation:

The numerator for this measurement is calculated based on the following:

1.  The number of patients in the denominator that have had an HbA1c >9.0%.  This should be documented using the following SMARText code in the Summary Interventions field or the encounter Plan field using "PQRIdmA1c": 3046F.

Denominator Calculation:

The denominator for this measurement is calculated based on the following:

1.  The number of patients that were between 18 and 74 years of age by the start of reporting period and have at least one face-to-face encounter with the provider during the reporting period;

2.  And have a diagnosis of Diabetes (recorded by using one of the ICD9 codes listed below) must be recorded in the patient's Summary Active Problems field OR encounter Assessment field:

250, 250.0, 250.00, 250.01, 250.02, 250.03, 250.10, 250.11, 250.12, 250.13, 250.20, 250.21, 250.22, 250.23, 250.30, 250.31, 250.32, 250.33, 250.4, 250.40, 250.41, 250.42, 250.43, 250.50, 250.51, 250.52, 250.53, 250.60, 250.61, 250.62, 250.63, 250.7, 250.70, 250.71, 250.72, 250.73, 250.8, 250.80, 250.81, 250.82, 250.83, 250.9, 250.90, 250.91, 250.92, 250.93, 357.2, 362.0, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06, 362.07, 366.41, 648.0, 648.00, 648.01, 648.02, 648.03, 648.04

Report Clinical Quality Measures to CMS/States

All of the items listed in the above steps need to be documented as structured data (as detailed above) in order to allow the user to capture the numerator, denominator and percentage for this quality measure.

For information on how to export the numerator, denominator and percentage for each Clinical Quality Measure, click here.

For more information on reporting clinical quality measures, click here.