Thank you for your question about the HbA1c for CMS122. The intent of the measure is for a patient to meet numerator criteria if (1) the patient's most recent HbA1c level is greater than 9.0% or (2) the patient’s most recent HbA1c is missing, or (3) an HbA1c check was not performed during the measurement period. Unfortunately, a fructosamine test cannot be added to this measure because it does not meet the measure's intent. A test result for fructosamine will not meet the numerator criteria unless uses a code from the "HbA1c Laboratory Test" value set. Equivalent services can be mapped to the measure's value set. If mapping is done, you should maintain documentation in case of a CMS audit.

Some patients, due to a red blood cell issue, cannot get a reliable blood sugar figure from an A1c check. Their diabetes is managed by doing a test for fructosamine. It was suggested to map the fructosamine measure to LOINC 4548-4, but that is not reccommended due to it having a completely separate LOINC. Is it possible to add in the fructosamine measure result to allow it to be considered as meeting the A1c metric?