Diabetes: Medical Attention for Nephropathy

Last updated: October 25, 2017

CMS Measure ID: CMS134v6
Version: 6
NQF Number: 0062
Measure Description:

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy 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:

Exclude patients who were in hospice care during the measurement year

Numerator Statement:

Patients with a screening for nephropathy or evidence of nephropathy during the measurement period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Previous Version: Diabetes: Medical Attention for Nephropathy
Improvement Notation:

Higher score indicates better quality

Guidance:

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

Addendum Notes: Value Set content updated Sept 2017

Specifications

Release Notes

Header

  • ​Incremented eMeasure Version number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • ​Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • ​Updated Disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated Clinical Recommendation Statement to reflect updated clinical guidelines.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated References.

    Measure Section: Reference

    Source of Change: Measure Lead

  • ​Updated the exclusion statement in the header to exclude patients in hospice care from the Denominator. Measures that focus on screenings and procedures may not be appropriate or a priority for those who are at end of life (ie, on hospice).

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

Logic

  • Added new lines of logic to the Denominator Exclusions for all NCQA-stewarded measures (except CMS82) to ensure patients in hospice care are excluded from the Denominator.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Kidney Transplant (2.16.840.1.113883.3.464.1003.109.12.1012): Deleted 1 SNOMEDCT code (48994000).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Diabetes (2.16.840.1.113883.3.464.1003.103.12.1001): Added 32 SNOMEDCT codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dialysis Services (2.16.840.1.113883.3.464.1003.109.12.1013): Added 1 SNOMEDCT code (714749008).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Urine Protein Tests (2.16.840.1.113883.3.464.1003.109.12.1024): Added 4 LOINC codes (76401-9, 77158-4, 77253-3, 77254-1).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Encounter Inpatient (2.16.840.1.113883.3.666.5.307): Added Encounter Inpatient.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15): Added Hospice care ambulatory.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Discharged to Health Care Facility for Hospice Care (2.16.840.1.113883.3.117.1.7.1.207): Added Discharged to Health Care Facility for Hospice Care.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Discharged to Home for Hospice Care (2.16.840.1.113883.3.117.1.7.1.209): Added Discharged to Home for Hospice Care.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set ESRD Monthly Outpatient Services (2.16.840.1.113883.3.464.1003.109.12.1014): Added 10 CPT codes (90951, 90952, 90953, 90954, 90955, 90956, 90963, 90964, 90967, 90968).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set ACE Inhibitor or ARB (2.16.840.1.113883.3.526.3.1139): Deleted 10 RXNORM codes (1011718, 1011729, 199850, 199919, 251856, 310139, 401965, 401968, 858618, 858621).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Kidney Failure (2.16.840.1.113883.3.464.1003.109.12.1028): Added 5 SNOMEDCT codes (722098007, 722149000, 722150000, 722467000, 723190009).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Glomerulonephritis and Nephrotic Syndrome (2.16.840.1.113883.3.464.1003.109.12.1018): Added 30 SNOMEDCT codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Urine Protein Tests (2.16.840.1.113883.3.464.1003.109.12.1024): Added 10 LOINC codes (13986-5, 13992-3, 17819-4, 29946-1, 49002-9, 50209-6, 51190-7, 6941-9, 6942-7, 77940-5) and deleted 1 LOINC code (77158-4).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Diabetes (2.16.840.1.113883.3.464.1003.103.12.1001): Added 2 ICD10CM codes (E11.10, E11.11). Added 21 SNOMEDCT codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Other Services Related to Dialysis (2.16.840.1.113883.3.464.1003.109.12.1015): Added 5 SNOMEDCT codes (717738008, 718019005, 718308002, 718330001, 718331002).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

External Resources