Key measure updates:

• Colorectal cancer screening will widen its age range to 45-75 years of age to reflect the U.S. Preventative Task Force (USPTF) recommendation and NCQA specifications. This update will be reflected for both the commercial and Medicare populations.
• Kidney evaluation for patients with diabetes (KED) has been added to both Medicare and commercial adult measure sets.
• To continue to drive performance, an osteoporosis management bonus has been added. See your PQIP booklet for details.
• Lead screening was added to the commercial child and adolescent measure set and is now included in the child and adolescent aggregate star score.

• Chlamydia screening was added to the commercial child and adolescent measure set and is now included in the child and adolescent aggregate star score.    
• The child and adolescent well-child measure age range was expanded to now include to total population of 3-21 years of age.

New measure focus: Kidney evaluation for patients with diabetes (KED)

Measure description: Members ages 18-85 with diabetes (type 1 and type 2) who received a kidney health evaluation, defined by an estimated glomerular filtration rate (eGFR) and a urine albumin -creatinine ratio (uACR), during the measurement year.

What closes the gap:

1. Estimated glomerular filtration rate (eGFR) lab test
   • Codes to identify estimated glomerular filtration rate (eGFR) lab test: CPT codes: 80047, 80048, 80050, 80053, 80069, 82565
   • LOINC codes: 48642-3, 48643-1, 50044-7, 50210-4, 50384-7, 62238-1, 69405-9, 70969-1, 77147-7, 88293-6, 88294-4, 94677-2, 96591-3, 96592-1, 98979-8,98980-6

AND

2. Urine creatinine (uACR) lab test
   • Codes to identify urine creatinine (uACR) lab test: urine albumin creatinine ratio test: LOINC codes: 13705-9, 14958-3, 14959-1, 30000-4, 32294-1, 44292-1, 59159-4, 76401-9, 77253-3, 77254-1, 89998-9, 9318-7. 

Nota: Urine albumin test and urine creatinine test: CPT category codes: 82043 and 82570; service dates of these two tests must be completed four days or less apart.

For more information on PQIP 2023, or to connect with a BCBSRI quality concierge nurse to enhance your practice’s quality processes or quality representative, please refer to your PQIP booklet or contact QualityHEDIS@bcbsri.org.