Diabetes: Hemoglobin A1c Poor Control

Last updated: July 12, 2017

CMS Measure ID: CMS122v4
Version: 4
NQF Number: 0059
Measure Description:

Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

Initial Patient Population:

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

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

None

Numerator Statement:

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

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Next Version: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)
Previous Version: Diabetes: Hemoglobin A1c Poor Control
Measure Score: Proportion
Improvement Notation:

Lower score indicates better quality

Guidance:

Patient is numerator compliant if most recent HbA1c level >9%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period.

Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.

Specifications

Release Notes

Header

  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.

Logic

  • Changed data type of 'result' or 'finding' to 'performed'.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced the new timing operator 'overlaps' to replace two lines of logic (AND/AND NOT) or to enforce when an event or set of events occur to meet the measure intent.
  • Removed 'starts after start of 'Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test'' from numerator logic. Change will allow for patients without a lab test result accompanying their lab test to be numerator compliant for this inverse measure.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator

Value Sets

  • Value set Diabetes (OID 2.16.840.1.113883.3.464.1003.103.12.1001): Added 54 ICD10CM codes.

External Resources