eMeasure Title

Hemoglobin A1c Test for Pediatric Patients

eMeasure Identifier (Measure Authoring Tool) 148 eMeasure Version number 5.1.000
NQF Number Not Applicable GUID 95fb767e-0cb2-4778-b5ff-6ba9a53fa28e
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward National Committee for Quality Assurance
Measure Developer National Committee for Quality Assurance
Endorsed By None
Description
Percentage of patients 5-17 years of age with diabetes with a Hemoglobin A1c (HbA1c) test during the measurement period
Copyright
Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). 

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(C) 2008-2016 National Committee for Quality Assurance. All Rights Reserved. 

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation. ICD-10 copyright 2015 World Health Organization. All Rights Reserved. Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA).
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

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Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body's inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes may cause life-threatening, life-ending or life-altering complications, including poor circulation, nerve damage or neuropathy in the feet and eventual amputation. Nearly 60-70 percent of diabetics suffer from mild or severe nervous system damage (American Diabetes Association 2009).

Even though most target recommendations for glycemic control have been based on data obtained from studies of adult patients with diabetes, the ideal goal of near-normalization of blood glucose levels in children and adolescents is generally the same as that for adults. However, special consideration must be given to the unique risks of hypoglycemia in young children (Silverstein et al. 2005).
Clinical Recommendation Statement
1. American Association of Clinical Endocrinologists (2002): 
Recommends that a glycosylated hemoglobin be performed during an initial assessment and during follow-up assessments, which should occur at no longer than three-month intervals.

2. American Diabetes Association (2006): 
Recommends obtaining a glycosylated hemoglobin during an initial assessment and then routinely as part of continuing care. In the absence of well-controlled studies that suggest a definite testing protocol, expert opinion recommends glycosylated hemoglobin be obtained at least twice a year in patients who are meeting treatment goals and who have stable glycemic control and more frequently (quarterly assessment) in patients whose therapy was changed or who are not meeting glycemic goals.
Improvement Notation
Higher scores indicate better quality
Reference
American Diabetes Association. 2009. "Standards of Medical Care in Diabetes-2009." Diabetes Care 2009 32(Suppl 1):S6-S12.
Reference
American Diabetes Association. 2006. "Standards of medical care in Diabetes-2006." Diabetes Care 29(suppl1):S4-42.
Reference
American Association of Clinical Endocrinologists. 2002. "Medical Guidelines for the Management of Diabetes Mellitus: The AACE System of Intensive Diabetes Self-Management-2002 Update." Endocr Pract 8(suppl 1):40-82.
Reference
Silverstein, J., G. Klingensmith, K. Copeland, L. Plotnick, F. Kaufman, L. Laffel, L. Deeb, M. Grey, B. Anderson, L. Holzmeister, N. Clark, 2005. "Care of Children and Adolescents With Type 1 Diabetes. A statement of the American Diabetes Association." Diabetes Care, 28(1), 186-212. http://care.diabetesjournals.org/content/28/1/186.long
Definition
None
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
Transmission Format
TBD
Initial Population
Patients 5 to 17 years of age with a diagnosis of diabetes where the diagnosis overlaps the most recent visit during the measurement period
Denominator
Equals Initial Population
Denominator Exclusions
None
Numerator
Patients with documentation of date and result for a HbA1c test during the measurement period
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Table of Contents


Population Criteria

Data Criteria (QDM Variables)

Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables


Measure Set
None