Diabetes Value Set Includes Gestational Diabetes ICD-9 Codes

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Priority: Moderate
    • Component/s: None
    • None
    • Michael Grabowski
    • Sparrow Health System
    • ​The 648.00 codes are for women who have diabetes before they become pregnant. The ICD9 code for gestational diabetes is 648.8 and it's not in our value set.
    • CMS131v6/NQF0055, CMS123v6/NQF0056, CMS122v6/NQF0059, CMS134v6/NQF0062
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      The diabetes value set (2.16.840.1.113883.3.464.1003.103.12.1001) includes several ICD-9 codes for gestational diabetes (648.00, 648.01, 648.02, 648.03, 648.04).

      This causes patients with gestational diabetes to be included in the initial patient population of diabetic quality measures. We noticed that there are no gestational diabetes ICD-10 diagnoses in the value set, so it appeared to be an oversight.

      Our current EMR (Epic) and ICD vendor (IMO), continue to maintain dual coding for diagnoses, so as our providers diagnose patients with gestational diabetes using ICD-10, but the system also records the legacy ICD-9 code for the diagnosis, which causes gestational diabetes patients to qualify for diabetic quality measures.

      Can the old gestational diabetes ICD-9 codes be removed from the value set or are they there for some historical purpose?
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      The diabetes value set (2.16.840.1.113883.3.464.1003.103.12.1001) includes several ICD-9 codes for gestational diabetes (648.00, 648.01, 648.02, 648.03, 648.04). This causes patients with gestational diabetes to be included in the initial patient population of diabetic quality measures. We noticed that there are no gestational diabetes ICD-10 diagnoses in the value set, so it appeared to be an oversight. Our current EMR (Epic) and ICD vendor (IMO), continue to maintain dual coding for diagnoses, so as our providers diagnose patients with gestational diabetes using ICD-10, but the system also records the legacy ICD-9 code for the diagnosis, which causes gestational diabetes patients to qualify for diabetic quality measures. Can the old gestational diabetes ICD-9 codes be removed from the value set or are they there for some historical purpose?

          Assignee:
          Mathematica EC eCQM Team (Inactive)
          Reporter:
          Michael Grabowski (Inactive)
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