QCDR Measure Specifications

Diabetes Care All or None Outcome Measure: Optimal Control

Measure ID: WCHQ10
Measure Name: Diabetes Care All or None Outcome Measure: Optimal Control
NQS Domain: Effective Clinical Care
Measure Type: Intermediate Outcome
Care Settings: Ambulatory Care: Clinician Office/Clinic
Meaningful Measure Area: Management of Chronic Conditions
NQF Number: N/A
Denominator Description: Patients with diabetes 18-75 years of age and alive as of the last day of the measurement period.
A minimum of two diabetes coded office visits and must be seen by a PCP / Endocrinologist for two office visits in 24 months and one office visit in 12 months.
Denominator Exclusions: Gestational Diabetes is excluded.
Numerator Description:
  • Most recent A1C is less than 8.0% AND
  • Most recent BP is less than 130/80 mm Hg AND
  • Most recent tobacco status is Tobacco Free (NOTE: If there is No Documentation of Tobacco Status the patient is not compliant for this measure) AND
  • Daily Aspirin or Other Antiplatelet for Diabetes Patients with the Diagnosis of Ischemic Vascular Disease Unless Contraindicated. (NOTE: If there is no diagnosis of IVD, the patient is automatically numerator compliant for this measure) AND
  • Statin Use (NOTE: If the patient is less than age 40 and there is no diagnosis of IVD, the patient is automatically numerator compliant for this measure)
Numerator Exclusions: None
Risk Adjusted?: No
Performance Rates Required: 1
High Priority?: Yes
Inverse Measure?: No
Result Type: Proportional

Diabetes Care All or None Process Measure: Optimal Testing

Measure ID: WCHQ09
Measure Name: Diabetes Care All or None Process Measure: Optimal Testing
NQS Domain: Effective Clinical Care
Measure Type: Process Care
Care Settings: Ambulatory Care: Clinician Office/Clinic
Meaningful Measure Area: Management of Chronic Conditions
NQF Number: N/A
Denominator Description: Patients with diabetes 18-75 years of age and alive as of the last day of the measurement period.
A minimum of two diabetes coded office visits and must be seen by a PCP / Endocrinologist for two office visits in 24 months and one office visit in 12 months.
Denominator Exclusions:
  • Non-warranted eGFR
  • Gestational Diabetes is excluded
  • Patient was a permanent nursing home resident at any time during the measurement period
  • Patient was in hospice or receiving palliative care at any time during the measurement period
  • Patient died prior to the end of the measurement period
  • Patient was pregnant (Diabetes with Pregnancy Value Set) at any time during measurement period
Numerator Description:
  • Two A1C tests AND
  • One kidney function test and/or diagnosis and treatment of kidney disease AND
  • One eGFR test annually
  • All of the above are during the time period specified by the measure
Numerator Exclusions: None
Risk Adjusted?: No
Performance Rates Required: 1
High Priority?: No
Inverse Measure?: No
Result Type: Proportional
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