Diabetes: Low Density Lipoprotein (LDL) Management

Last updated: May 3, 2018

CMS Measure ID: CMS163v4
Version: 4
NQF Number: None
Measure Description:

Percentage of patients 18-75 years of age with diabetes whose LDL-C was adequately controlled (<100 mg/dL) 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:


Numerator Statement:

Patients whose most recent LDL-C level performed during the measurement period is <100 mg/dL

Numerator Exclusions:

Not Applicable

Denominator Exceptions:


Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Next Version:
Previous Version:
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality


The patient is not numerator compliant if the result for the most recent LDL-C test during the measurement period is >= 100 mg/dL, or is missing, or if an LDL-C test was not performed 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.


Release Notes


  • eMeasure version number incremented.
  • Copyright updated.
  • NQF Number and Endorsed By fields updated to reflect measures no longer endorsed by NQF.


  • 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.
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • Replaced 'ORs' with 'Union of' operator.
  • 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.

Value Sets

  • Value set Diabetes (OID 2.16.840.1.113883.3.464.1003.103.12.1001): Added 54 ICD10CM codes.
  • Replaced value set LDL-C Laboratory Test (OID 2.16.840.1.113883.3.526.3.1248) with the value set LDL-c (OID 2.16.840.1.113883. to harmonize the LDL-C value sets across measures.

External Resources