Table 1.
Condition/utilization | Administrative codea | |
---|---|---|
Study inclusion requirements | ||
Diabetes mellitus | ICD-9: | 250.xx |
Study outcomes | ||
Congestive heart failure | ICD-9: | 428.xx 398.91 402.01 402.11 402.91 404.11 404.91 |
Acute myocardial infarctionb | ICD-9: | 410.xx |
Stroke/transient ischemic attackb | ICD-9: | 431.xx 435.xx 436.xx 434.01 434.91 434.11 |
Insulin dependence | ICD-9: | 250.1× 250.3× 250.01 259.03 |
Cardiovascular complication | ||
Angina | ICD-9: | 413.xx |
Ischemic heart disease | ICD-9: | 411.xx 414.xx |
Cerebrovascular complication | ||
Carotid bruit | ICD-9: | 785.9 |
Occlusion or stenosis | ICD-9: | 433.xx 434.xx |
Elements of adherence to diabetes treatment guidelines | ||
General physician visit | CMS: | 01 08 11 70 50 97 |
Specialist physician visit | CMS: | 46 39 06 48 |
Eye specialist visit | CMS: | 18 41 |
Blood pressure test | CPT-4: | 90201 90205 99211–99215 99241–99245 99301–99303 99311–99313 99321–99323 99341–99349 99350 99387 99397 99401–99404 99411 99412 9942× 99331–99333 |
Urine test | CPT-4: | 81001–81005 82040 82042 82043 82044 84155 |
HB1AC test | CPT-4: | 82985 83036 |
Lipid test | CPT-4: | 80061 82465 83715–83719 83721 84478 |
Elements of adherence to prescribed medicationsc | ||
Diabetes | Metformin, sulfonylureas, meglitinides, thiazolidinediones | |
Cardiac | Diuretics, sympatholytics, ACE inhibitors, calcium channel blockers, angiotensin 2 antagonists, vasodilators, anticoagulants |
Note. ICD-9 = International Classification of Diseases, Ninth Revision; CMS = U.S. Centers for Medicare & Medicaid Services; CPT-4 = Current Procedural Terminology, Version 4; ACE inhibitors = Angiotensin-converting-enzyme inhibitors.
Codes are drawn from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 for condition, ICD-9(P) for procedure), CPT-4 and CMS specialty codes. Codes are supplemented by questionnaire data where available.
Includes Part A inpatient claims only.
Includes all brand and generic names in drug group.