Part B News PQRI series: Quality measure breakdown Use this table to code Diabetes measures

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a Physician Quality Reporting Initiative (PQRI) table focused on diabetes-related quality measures. It is intended for clinicians and coding professionals who need a broad view of the reporting categories, the specialty areas involved, and the general types of measurement and billing references included in the table.

Why This Topic Matters

It helps readers understand whether the article applies to diabetes management or diabetic retinopathy quality reporting and whether it is relevant to PQRI-era reporting workflows.

Article Sections

  1. Quality Measure and conditions

    Introduces the measure categories and the code columns used in the table. It frames the content around diabetes management and diabetic retinopathy reporting.

  2. Diabetes Mellitus (DM) Type I or II: Hemoglobin A1c control

    Covers the quality measure category related to diabetes monitoring and the associated reporting elements for the measure. The section presents the broad reporting context for patients in the specified age range.

  3. DM Type I or II: Low Density Lipoprotein control

    Describes the diabetes-related quality measure category focused on lipid monitoring. It presents the associated reporting structure for eligible patients.

  4. DM Type I or II: High blood pressure control

    Summarizes the diabetes-related blood pressure measure category. It includes the broad reporting framework for systolic and diastolic measurement components.

  5. Diabetic Retinopathy: macular edema or fundus exam and severity of retinopathy

    Addresses the ophthalmology-related diabetes quality measure category tied to retinal evaluation. It covers the general reporting context for documenting exam findings and retinopathy severity.

  6. Diabetic Retinopathy: macular edema or fundus exam results communicated to physician who provides primary diabetes management

    Covers the communication-focused retinopathy measure category. It describes the reporting context for sharing exam findings with the clinician managing diabetes.

What You Will Learn

  • How the article organizes PQRI diabetes quality measures by clinical category
  • Which broad diabetes management areas are addressed in the table
  • Which retinal care measures are included for diabetic retinopathy reporting
  • How the article frames the relationship between quality reporting and routine billing/coding references
  • What specialties and patient groups the measures are intended to cover

Who Should Read This

  • Physicians
  • Ophthalmologists
  • Medical coders
  • Quality reporting staff
  • Billing staff

Codes Discussed

Code Ranges Discussed

Modifiers Discussed


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