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 (Claims)
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.
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
- 4548-4
- 4549-2
- 17856-6
- 96595-4
SNOMED CT US Edition
- 43396009
- 313835008
HbA1c Test Result or Finding
CPT-CAT-II
- 3044F
- 3046F
- 3051F
- 3052F
SNOMED CT US Edition
- 165679005
- 451061000124104
LDL-C Lab Test
CPT
- 80061
- 83700
- 83701
- 83704
- 83721
LOINC
- 2089-1
- 12773-8
- 13457-7
- 18261-8
- 18262-6
- 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