URSA-CKD-901: Office Visits with HbA1c Results in Claims

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 Type: Rate Measure
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case 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

• Data Model Keys

  • Encounter ID
  • Patient ID
  • 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)

• 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

  • Is Numerator Last HbA1C <= 9 Code
  • Is Numerator Last HbA1C > 9 Code

• Measure Fields

  • Denominator
  • Numerator

• Module Fields

  • CKD Stage Category
  • Is ESRD
  • Is Chronic Dialysis Patient