Hemoglobin A1c Control for Patients With Diabetes (HBD)
HEDIS Measure
Hemoglobin A1c Control for Patients With Diabetes (HBD)
Line of business: Commercial Medicaid Medicare
Data Collection Method:
Administrative (Claims)
Hybrid (HEDIS Chart Chase)
Supplemental Data Submission
- Standard – Electronic Clinical Data System (ECDS) Layout
- Non-Standard - Medical Record
Measure Description
The percentage of members 18–75 years of age with diabetes (types 1 and 2) whose hemoglobin A1c (HbA1c) was at the following levels during the measurement year:
- HbA1c control (<8.0%).
- HbA1c poor control (>9.0%). (Inverted Measure)
Numerator Compliance
HbA1c Control <8% - The most recent HbA1c test during the measurement year with a result of <8.0%
NOTE: The member is not compliant if the result for the most recent HbA1c test is equal to or greater than 8.0%
HbA1c Poor Control >9% - The most recent HbA1c test during the measurement year with a result of >9.0%
NOTE: The member is not compliant if the result for the most recent HbA1c test is equal to or less than 9.0%
Best Practices
- Order labs prior to members' appointments
- Ensure documentation in the medical record includes the date when the HbA1c was performed, and the result
- Order a diabetes screening test 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 cancel appointments and reschedule them as soon as possible
- Follow up with patients to discuss and educate on effects of diabetes
- Coordinate care with patients' other providers
- Outreach patients who have not had their eye exam and lab work completed and ask them to complete as soon as possible
- Discuss with member the Importance of screening for diabetes
- Educate the member on symptoms of new-onset diabetes
- Set care gap “alerts” in your electronic medical record
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 Level Greater Than or Equal To 7.0 and Less Than 8.0
CPT-CAT-II
- 3051F
HbA1c Level Less Than 7.0
CPT-CAT-II
- 3044F
SNOMED CT US Edition
- 165679005
HbA1c Test Result or Finding
CPT-CAT-II
- 3044F
- 3046F
- 3051F
- 3052F
SNOMED CT US Edition
- 165679005
- 451061000124104
HbA1c Level Greater Than 9.0
CPT-CAT-II
- 3046F
SNOMED CT US Edition
- 451061000124104
HbA1c Level Greater Than or Equal To 8.0 and Less Than or Equal To 9.0
CPT-CAT-II
- 3052F