001. Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Document the diabetic patient’s A1c levels:

1. Open the Ocular Exam.
2. Select a diabetes Diagnosis.
3. Select a counseling Plan.
4. Select the appropriate condition from the Quality 1 drop-down.

Alternatively, code quality with a special plan:

1. Open the Ocular Exam.
2. Select a Diagnosis and Plan.
3. Tap Special Plans and select MIPS.
4. From Popular Plans, select MIPS Quality.
5. Tap the Diabetes tab.
6. Select the appropriate condition from the Quality 1 drop-down.
7. Tap Done.

Document the diabetic patient’s A1c levels:

1. In a patient’s exam record in ExamWRITER, record the office visit.
2. Click the Patient Hx - ROS tab.
3. Click the Review of Systems bar.
4. Select Endocrine and click Process.
5. Select one of the following check boxes:
   • A1c Patient Reported
   • Diabetes Managed Phy Documented
   • Performed Procedure
6. Select the A1c level from the check boxes or enter the A1c manually.

   Based on your selection, ExamWRITER will autocode the following CPT Category II codes:

   • 3044F (A1c level < 7%)
   • 3051F (A1c level 7.0% to 7.9%)
   • 3052F (A1c level 8.0% to 9.0%)
   • 3046F (A1c level > 9% or test not performed)
7. Click Process.

Eyefinity products and documentation refer to the MIPS quality numbers. Other measure numbering systems are listed here for your reference.

Quality	1
NQF	0059
CMS	122

• Claims
• EHR (ExamWRITER only)
• Registry (Eyefinity EHR only)

Reporting methods vary by measure and EHR system. For more information about how different measures and reporting methods are scored, refer to the topic that corresponds with your EHR:

• Eyefinity EHR Quality Scoring and Benchmarking
• ExamWRITER Quality Scoring and Benchmarking

Patients aged 18 to 75 years;

AND who had a diagnosis of diabetes:

AND who had a visit during the measurement period:

Denominator Exclusions

Hospice services given to patient any time during the measurement period:

Patients age 66 and older in Institutional Special Needs Plans (SNP) or residing in long-term care with a POS code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period:

Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period AND a dispensed medication for dementia during the measurement period or the year prior to the measurement period :

Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period AND either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ED or non-acute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period:

Patients who are included in the denominator

AND whose most recent HbA1c level (performed during the measurement period) is > 9.0%

Performance Met

Most recent hemoglobin A1c level is greater than 9.0%:

OR hemoglobin A1c level was not performed during the measurement period (12 months):

Performance Not Met

Most recent hemoglobin A1c (HbA1c) level is less than 7.0%:

OR most recent hemoglobin A1c (HbA1c) level is 7.0 to 9.0%: