Measure Description
Among clinician office visits for patients with diabetes and with an HbA1c performed in the prior 6 months, the percentage with documentation of HbA1c results from that test prior to or following the visit. (Lower values indicate under-documentation of HbA1c results.)
Metadata
- Measure Identifier: URSA-CKD-901
- Measure Type: Rate Measure
- Temporal Structure: Event
- Component Class: Normal-Form
- Case Field: Encounter ID
- Observation Field: Encounter ID
- Target Direction: Up
Denominator Description
Clinician office visits for patients with diabetes and with a performed HbA1c in the prior 6 months
Numerator Description
Denominator cases with documentation via claims of any HbA1c result between 6 months prior to the visit to 2 weeks following
Published Fields
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Data Model Keys
- Encounter ID -- The internal database identifier (used, e.g., for joins and primary keys) for the encounter. (See also [URSA-CORE] Encounter)
- Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
- Numerator Document ID
-
Date Fields
- Encounter Date
- Performed A1c Date
- Numerator Document Effective Date
- Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
- Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
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Provider Fields
- CKD Physician Management Category
- Plan Attributee Provider Description
- Empirical Attributee Nephrology Group Provider Description
- Empirical Attributee Primary Care Provider Group Description
- Visit Provider Group Description
-
Clinical Services Fields
- Performed A1c HCPCS Code
-
Diagnostic Fields
- undefined
- undefined
-
Measure Fields
- Denominator
- Numerator
-
Module Fields
- CKD Stage Category -- The stage of a patient’s chronic kidney disease (CKD), for stage 1 through stage 5 and ESRD. Stage is only calculated for patients already meeting the criteria for CKD. Stage is determined by a combination of the following: (1) ICD-10-CM codes specific to a particular stage; (2) eGFR lab results within certain bands associated with a stage (see below); (3) identification of the patient in a CMS Monthly Membership Report as an ESRD beneficiary; (4) documentation of a prior kidney transplantation surgery; and/or (5) status as a chronic dialysis patient. The patient’s CKD stage can change over time, so a patient timeline data structure is appropriate.
The following eGFR bands are used:
GFR >= 90: Stage 1;
60 <= GFR < 90: Stage 2;
30 <= GFR < 60: Stage 3;
15 <= GFR < 30: Stage 4;
GFR < 15: Stage 5.
The appropriate race-specific eGFR lab is used when the patient's race is known. (See also [URSA-CKD] Is Chronic Dialysis Patient, [URSA-CKD] Kidney Transplantation Surgery Encounter)
- Is ESRD -- The stage of a patient’s chronic kidney disease (CKD), for stage 1 through stage 5 and ESRD. Stage is only calculated for patients already meeting the criteria for CKD. Stage is determined by a combination of the following: (1) ICD-10-CM codes specific to a particular stage; (2) eGFR lab results within certain bands associated with a stage (see below); (3) identification of the patient in a CMS Monthly Membership Report as an ESRD beneficiary; (4) documentation of a prior kidney transplantation surgery; and/or (5) status as a chronic dialysis patient. The patient’s CKD stage can change over time, so a patient timeline data structure is appropriate.
The following eGFR bands are used:
GFR >= 90: Stage 1;
60 <= GFR < 90: Stage 2;
30 <= GFR < 60: Stage 3;
15 <= GFR < 30: Stage 4;
GFR < 15: Stage 5.
The appropriate race-specific eGFR lab is used when the patient's race is known. (See also [URSA-CKD] Is Chronic Dialysis Patient, [URSA-CKD] Kidney Transplantation Surgery Encounter)