Diabetes care process | Definition | Guidelines3 |
Blood pressure (BP) | At least one recorded value for systolic or diastolic BP per year | <130/80 mm Hg |
HbA1c | At least one recorded value for HbA1c per year | <7.0% |
Cholesterol | At least one recorded value for cholesterol per year | LDL<100 mg/dL |
Creatinine | At least one recorded value for creatinine per year | Used to estimate eGFR* |
Urine-albumin-creatinine ratio (UACR) | At least one recorded value for UACR per year | <30 mg/g |
Eye examination† | At least one procedure code record for eye examination per year | n/a |
Foot examination‡ | At least one procedure code record for foot examination per year | n/a |
*There are no guideline-specific cut-offs for creatinine. Instead, in combination with other factors such as age, sex and body surface area, creatinine is used to determine the estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is preferred. eGFR is not reported here.
†CPT codes: 92002, 92004, 92012, 92014, 92015, 99172 and 99173.
‡CPT codes: G0245, G0246, G0247, G9226, 11055, 11056, 11057, 11719, 11720, 11721, S0390
CPT, Current Procedural Terminology; LDL, low-density lipoprotein.