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A1c HbA1c Hemoglobin A1c Glycohemoglobin A1c HgbA1c on an ambulatory basis Table CDCA ; . Claim Encounter Data: Patients who had two faceto-face encounters with different dates of service in an outpatient setting or nonacute inpatient setting or one face-to-face encounter in an acute inpatient or emergency department ED ; setting during the measurement year or the year prior to the measurement year with a diagnosis of diabetes. Services that occur over both years may be counted. Use the codes in Table CDC-B to identify a diabetes diagnosis and Table CDC-C to identify the visit type. Table CDC-B to identify a diagnosis of diabetes and the codes in CDC-M to identify a diagnosis of polycystic ovaries. Exclude patients with gestational diabetes or steroidinduced diabetes, who did not have any face-to-face encounters with the diagnosis of diabetes in any setting ; , during the measurement year or year prior to the measurement year. Diagnosis of gestational diabetes or steroidinduced diabetes can occur during the measurement year or the year prior to the measurement year, but must have occurred by December 31 of the measurement year. Use the codes in Table CDC-B to identify a diagnosis both confirm information in the sampling framework for the denominator and for determination Note: Removed Glucophage metformin from Table CDC-A in HEDIS 2005. Diabetic patients on of the these medications are identified through diagnosis coding only. NCQA's Web site at ncqa numerator. will provide a list of medications by November 15, 2006. Table CDC-B: Codes to Identify Diabetes Description ICD-9-CM Diagnosis DRG Byetta Exenatide ; -- Oral Chlorpropamide Glucovance GlyburideMetformin ; Glyburide Prandjn Repaglinid e ; Diabetes 250, 357.2, 362.0, Table CDC-C: Codes to Identify Visit Type Description CPT Outpatient 92002-92014, 99201-99205, 99211-99215, Nonacute 99301-99313, 99315, 99316, inpatient 99318, 99321-99328, 99331-99337 Acute inpatient 99221-99223, 99231-99233, 99238, Emergency 99281-99285 department Table CDC-D: Codes to Identify HbA1c Tests CPT CPT Category II 83036, 83037 3046F, systematic sample from the population listed above should be determined using the most accurate data available in the settings in which the measure will be implemented. The measure developer recommends that in most settings office visit claims see list of codes ; or other codified encounter data should be used to identify patients who have had at least one office visit in the prior 12 ; months from which a purposeful sample random, consecutive retrospective or prospective from a specific date ; can then be chosen for the denominator. In other uses of the measure, insurer level claims pooled or single insurer ; data can be used to identify the denominator. of diabetes and the codes in CDC-M to identify gestational diabetes and steroid-induced diabetes. MEDICAL RECORD SPECIFICATION: Exclude patients with a diagnosis of polycystic ovaries on the problem list who did not also have a diagnosis of diabetes on the problem list during the measurement year or year prior to the measurement year. Exclude patients with a diagnosis of gestational diabetes or steroidinduced diabetes on the problem list during the measurement year. Table CDC-M: Codes to Identify Exclusions Description ICD-9-CM Diagnosis and pantoprazole.
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