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Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)

HEDIS Measure

Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD)

Line of business: Medicaid

Data Collection Method: Administrative

Measure Description

The percentage of members 18–64 years of age with schizophrenia or schizoaffective disorder and diabetes who had both an LDL-C test and an HbA1c test during the measurement year.

Numerator Compliance

An HbA1c test and an LDL-C test performed during the measurement year (on the same or different dates of service). The member must have both tests. The organization may use a calculated or direct LDL.

Best Practices

  • Order screening tests every year and build care gap “alerts” in your electronic medical record
  • Follow up with patients to discuss and educate on lab results
  • Coordinate care with patients’ other providers
  • Outreach patients who have not had their labs done and ask them to complete as soon as possible
  • Encourage shared decision-making by educating patients and caregivers about increased risk of diabetes
  • Discuss with member the Importance of screening for diabetes
  • Educate the member on symptoms of new-onset diabetes

Quality Value Set Directory Coding Tips

HbA1c Lab Test

CPT

  • 83036
  • 83037

LOINC

  • 17856-6
  • 4548-4
  • 4549-2

SNOMED CT US Edition

  • 43396009
  • 313835008

HbA1c Test Result or Finding

CPT-CAT-II

  • 3044F
  • 3046F
  • 3051F
  • 3052F

SNOMED CT US Edition

  • 165679005
  • 451051000124101
  • 451061000124104

LDL-C Lab Test

CPT

  • 80061
  • 83700
  • 83701
  • 83704
  • 83721

LOINC

  • 12773-8
  • 13457-7
  • 18261-8
  • 18262-6
  • 2089-1
  • 49132-4
  • 55440-2
  • 96259-7

SNOMED CT US Edition

  • 113079009
  • 166833005
  • 166840006
  • 166841005
  • 167074000
  • 167075004
  • 314036004

LDL-C Test Result or Finding

CPT-CAT-II

  • 3048F
  • 3049F
  • 3050F