Table 1.

Specification of proposed SLE quality measures^*

Quality measure description	Denominator†	Numerator	Exclusions, exceptions	Measurement period
Renal disease screening: proportion of patients with SLE who had urinary screening for lupus nephritis at least once per year	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart	Patients with ≥1 documented urine study (urinalysis, urine protein, or urine protein:creatinine ratio)	ESRD (585.6, N18.6, Z99.2, CPT 90951- 90970)	1 calendar year (e.g., 1/1/2018–12/31/2018)
Blood pressure assessment: proportion of patients with SLE who had at least 2 blood pressure readings per year	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart	Patients with ≥2 blood pressure readings recorded ≥30 days apart	None	1 calendar year (e.g., 1/1/2018–12/31/2018)
Blood pressure uncontrolled: proportion of patients with SLE without adequate blood pressure control	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart, AND ≥2 blood pressure readings, ≥30 days apart	Patients with systolic blood pressure of >140 mm Hg or diastolic blood pressure of >90 mm Hg on ≥2 occasions, ≥30 days apart	None	1 calendar year (e.g., 1/1/2018–12/31/2018)
HCQ prescription: proportion of patients with SLE who were prescribed HCQ	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart	Patients with at least 1 prescription for HCQ	Toxic maculopathy of retina (H35.0, 381–383, 362.55) or poisoning, adverse effect of other specified systemic antiinfectives and antiparasitics (T37.8x, T37.9x, E931.4)	1 calendar year (e.g., 1/1/2018–12/31/2018)
Safe HCQ dosing: proportion of patients with SLE receiving HCQ prescribed doses associated with less retinal toxicity	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart, AND at least 1 prescription for HCQ	Patients prescribed ≤5.0 mg/kg/day of HCQ on their most recent prescription	None	1 calendar year (e.g., 1/1/2018–12/31/2018)
Glucocorticoid use of >7.5 mg/day for ≥90 days: proportion of patients with SLE who do not meet the Lupus Low Disease Activity Index glucocorticoid criteria (≤7.5 prednisone mg/day).	Patients with ≥2 face-to-face encounters with ICD codes for SLE, ≥30 days apart	Patients prescribed >7.5 mg of prednisone (or equivalent) for ≥90 days (not required to be continuous days)	None	1 calendar year (e.g., 1/1/2018–12/31/2018)

^*CPT = Current Procedural Terminology; ESRD = end-stage renal disease; HCQ = hydroxychloroquine; ICD = International Classification of Diseases; SLE = systemic lupus erythematosus.

^†SLE was defined using ICD codes 710.0, 710.00, or M32x (except M32.0).