Closing Gaps in Kidney Evaluation for Patients with Diabetes

Coding Reminder and Best Practices

This October, the HEDIS® measure for kidney evaluation in patients with diabetes (KED) will start to be reflected in the Medicare Star Ratings. This measure is already included in the NCQA Health Plan Ratings which apply to our US Family Health Plan (TRICARE Prime).

KED measure is satisfied when patients receive both kidney evaluation tests annually—eGFR and uACR.

Coding reminder:

We understand that apparent care gaps can be a matter of incorrect billing codes rather than care not being provided.

Option	Test	CPT Code	LOINC
	uACR	N/A	13705-9, 14958-3, 14959-1, 30000-4, 44292-1
	eGFR	80047, 80048	50044-7, 50210-4, 50384-7
	Urine creatinine	82570	20624-3, 2161-8, 35674-1
	Quantitative urine albumin	82043	100158-5, 14957-5, 1754-1

How Can We Close This Gap?

Several strategies can improve performance:

1. Patient Education: Explain the importance of kidney testing.
2. Leverage EHR Tools: Set up automatic screening flags.
3. Proactive Testing: Order tests ahead of appointments.
4. Care Coordination: Reach out to patients who missed testing.