Proposed Data Element Query Parameters for Basic DAF over DIRECT Use Case
Submitted by Stephen Beller on 7/12/14 – updated 7/31/14, 8/5/14
I attended the 7/9/14 Data Elements WG meeting and viewed to the 7/2 recording. In the meetings, presenters
discussed several query parameter logic, data and profile models—including QUICK & QIDAM, CQL, FHIR, QED,
QDM, vMR and QBPv3—and efforts to map these models to CDA/C-CDA and to each other (more or less). Much
work has been going into development of these standards and considerably more is needed. There are few
implementations acutally using them, partly due to technical complexities and non-technical (business layer)
issues.
Definitions
With this in mind, let’s consider the differing needs of the two primary use cases for implementing data element
queries via DAF Direct:
1. “Basic” use case includes situations in which: (a) a Responder’s EHR system cannot effectively handle
CDA OIDs or codes, parse XML, and/or utilize value sets stored only on the Web; (b) a Responder does
not want to rely on Web services for transport; or (c) a Responder does not have an EHR, but can do
patient chart reviews to supply the requested data. The Direct transport protocol for this use case would
typically be the “Simple SMTP” model (as per the Applicability Statement for Secure Health Transport).
2. “Complex” use case includes situations in which EHR system performs automated queries. The Direct
transport protocol for this use case would typically be the “SMTP with Full Service HISPs” model (as per
the Applicability Statement) and rely on SOAP or RESTful web-service transport protocols.
Rationale
The Basic use case would benefit many long term healthcare facilities, providers using CDA readers, EHR systems
that lack required querying capabilities, and Responders who prefer not to implement automated web-service
queries.
Since the main DAF WG has not focused on the Basic use case, I now propose a model that defines query
parameters for the Basic use case. This Basic parameter definition model would:
 Store the query parameters in a human readable file and in a standardized layout/structure using a
simple expression language
 Map the query parameters to HL7 CDA clinical concepts using standardized vocabularies and value sets.
In addition, it was proposed that the human readable file for Basic queries also be included in the payload sent
to responders of Complex queries to provide a description what is to be done (even when a query is automated).
This would avoid the issue of the query Requestor having to determine the Responder’s query capabilities.
Issue of Scope
During the 8/4/2014 SWG meeting, a question of arose about whether this Basic use case was in scope since it
was not addressed in the DAF Charter. I said this was an oversight that only became apparent in this SWG when
we examined the value of the Basic use case’s Simple SMTP transport in its ability to deliver any type of payload
and format in a zipped e-mail attachment without requisite SOAP headers, XDM packaging, XML and HL7
formats, etc.
Page 1 of 34
In an early meeting of the SWG, I mentioned a post to the wiki from Walter Sujansky in which his report -http://www.projecthealthdesign.org/media/file/Standard-Model-For-Collecting-And-ReportingPGHI_Sujansky_Assoc_2013-07-18.pdf -- included a description of a parameter definition model for
unstructured request/response messages over DIRECT, which he called the Basic Document Retrieval model.
Group members indicated that this unstructured data model is unacceptable for DAF since “unstructured” is not
an interoperable standard. This meant that structured model would be required even for very basic documentbased queries and, therefore, a structured parameter definition model for basic data element queries is alos
required.
In response, I designed a possible structure query definition model for the Basic use case, which I'm calling the
Query Parameters Definition Grid.
A related question was discussed about whether FHIR, which appears to be the likely standard to be selected by
the main DAF WG, would be a suitable structure for the Basic use case. Reasons why it would not be suitable
include the need to parse its XML or JASON data representations in FHIR and the uncertainty that FHIR’s
dependence on REST can be broken in order to deliver a FHIR-based payload via Simple SMTP.
The meeting concluded with members asking me to present my Basic model to the large DAF WG on 8/6, which I
will do so.
Query Parameters Definition Grid Components
I propose for that the query parameters for the Basic use case be stored in files that:
1. Represent the parameters in simple human readable format structured in a query parameters definition
grid (rather in using XML or HL7v2), as depicted in the Appendix, which uses a straight-forward
expression language.
2. Mirror the Complex use case for patient identifiers and demographics, as well as information related to
patient privacy, although representing them in the query parameters definition grid.
3. Include all relevant value sets as locally searchable lists (rather than requiring remote Web access).
4. Base the query parameters for clinical data elements and attributes on the C-CDA, which include the
following clinical catagories and subcategories
a. Advance directives
i. Directive Type
ii. Effective as of
iii. Expires on
iv. Patient's Directive
v. Document of Record
b. Allergies, adverse reactions, alerts
i. Vaccine
ii. Date
iii. Status
c. Family history
i. Relationship
ii. Diagnosis
iii. Age at onset
Page 2 of 34
d. Functional status
i. Functional or Cognitive Finding
ii. Observation
iii. Observation Date
iv. Condition Status
e. Immunizations
i. Vaccine
ii. Date
iii. Status
f. Medications
i. Intended Use
ii. Type
iii. Brand Name
iv. Generic Name
v. Drug Vehicle
vi. Medication Route
vii. Status
viii. Start Date
ix. End Date
x. Instructions
xi. Where to Administer
xii. Administrative Unit
xiii. Repeat Number
xiv. Precondition
xv. Frequency
xvi. Dose Quantity
xvii. Rate Quantity
xviii. Max Dose
xix. Indication
g. Medical equipment
i. Supply/Device
ii. Date supplied
h. Payers
i. Policy type / Coverage type
ii. Covered party ID
iii. Policy Holder
i. Plan of care
i. Planned activity
ii. Planned date
j. Problems
i. Condition
ii. Effective Dates
iii. Status
Page 3 of 34
k. Procedures
i. Procedure
ii. Date
l. Results
i. Laboratory test
ii. Test result value
iii. Reference range
m. Social history
i. Social history element
ii. Description
iii. Effective dates
n. Vital signs
i. Height
ii. Weight
iii. Blood Pressure
iv. etc.
5. Indicate Time variables as needed
a. Start date
b. End date
c. Effective time
d. Birth date
e. Years, months, days, hours, minutes, seconds
6. Indicate Status variables as needed
a. Aborted
b. Active
c. Cancelled
d. Completed
e. Held
f. Suspended
7. Indicate Quantity/Level/Degree variables as needed, e.g.:
a. Units of measure (other than time)
i. Measurement system
1. Imperial and US Customary system
2. Metric system
ii. Measurement type, including:
1. Length
2. Weight
3. Distance
4. Location
5. Volume
6. Frequency (number of occurances per time period)
7. Intensity (e.g., Mild/Moderate/Severe, Low/Medium/High)
8. Duration (time period during which something exists/occures)
Page 4 of 34
9. Count (number of units)
8. Indicate Mathematical and Logical Operators (e.g., <, >, ≤, ≥, ≠, =, and, or, not, else, any, none, contains,
does not contain, before, after) as needed
Page 5 of 34
Appendix: Example of Query Parameters Definition Grid and Value Sets Structure
Here’s an example of the proposed query parameters defintion grid and value sets structure for storing query
parameters in the Basic use case based on the rather complex NQF 0059 population health quality metric. It
requests a count of the number of patients in a defined popluation of diabetic patients (the denominator) and
the number of those patients with an HbA1c level >9.0% (the numerator).
Note 1: The values sets referenced in the Data Criteria/Value column are located beneath the query parameters
definition grid in the Diabetes-Related Value Sets section.
Note 2: If the query was for a single patient: (a) the Initial Patient Population Criteria section would be replace
with a Patient Identification section containing a patient’s identification information and (b) the Numerator and
Denominator sections would be replaced by a “Clinical Data Requested” section. I will provide an example of this
in the next version of this document.
Note 3: The structure of a Privacy Protection section is TBD.
Query Parameters Definition Grid
Description of Parameter
Data Category/Type
Data Criteria/Value
Measurement End Date
Measurement Period
Measurement End Date
2014-Aug-01
Initial Patient Population Criteria
Patient Age in years at the
Measurement End date is
between 18 and75
Patient Age
End Date - Birth Date >=18 years AND:
End Date - Birth Date <=75 years
Denominator Criteria
All patients in the Initial Patient Population
AND:
Medications criterion:
Medications indicative of
diabetes that are ordered,
dispensed or active <=2 years
before or simultaneously to the
measurement end date
Name or ID
State
Effective Time
In Diabetes Medications Value Set
=Ordered OR:
=Dispensed OR:
=Active
<=Measurement End Date – 2 Years
|OR: (If the medication criterion is not met)
Problem/Condition/Diagnosis
criterion: Active diabetes
diagnosis <=2 years before or
simultaneously to the
measurement end date
Exception: Active diagnosis of
polycystic ovaries, gestational
diabetes, or steroid induced
diabetes
Status
In Diabetes Diagnosis Codes & Names
Value Set
=Active
Effective Time
<=Measurement End Date – 2 Years
Problem-Condition
Problem-Condition
Status
Page 6 of 34
=polycystic ovaries OR:
=gestational diabetes OR:
=steroid induced diabetes
=Active
||AND: (If the medications criterion in not met, but the Problem/Condition/Diagnosis criterion is met, then
one of two Encounter criteria must also be met)
Encounter criterion: 1 or more
Type
In Acute Encounter Name Value Set
acute inpatient or ED encounters Effective Time
<=Measurement End Date – 2 Years
<=2 years before or
simultaneously to measurement Frequency
>=1 Encounter
end date
|||OR: { If the acute inpatient encounter criterion is not met, then the following must be met)
2 or more encounters in non‐
Type
In Non-Acute Encounter Name Value Set
acute inpatient, outpatient, or
Effective Time
<=Measurement End Date – 2 Years
ophthalmology occurring on
Frequency
>=2 Encounters
different dates
Numerator Criteria
Patients is in the Initial Patient Population
AND:
Laboratory test result HbA1c test
using HbA1c test code list
grouping during the
measurement period
Patients whose last HbA1c text
>9.0%
Lab Test Type
Effective Time
In Diabetes Lab Test Value Set
Most recent HbA1c Lab Test
Result Value
>9.0% mg/dl
Diabetes-Related Value Sets
Diabetes Diagnosis Codes & Names
Diabetes Diagnosis Codes
ICD-9-CM Diabetes Diagnosis Codes
>= 249
<=250.93
251.8
648.83
775.1
790.29
ICD-10-CM Diabetes Diagnosis Codes
E13.31
O24.42
R73.02
R73.09
E13.43
E13.33
E13.32
E13.35
E13.34
T38
Page 7 of 34
E28.2
E08
E10
E10.36
E11.36
SNOMED-CT Diabetes Diagnosis Codes
111552007
111558006
11530004
11687002
123763000
127013003
127014009
190321005
190328004
190330002
190331003
190336008
190353001
190361006
190368000
190369008
190371008
190372001
190383005
190389009
190390000
190392008
190406000
190407009
190410002
190411003
190412005
190416001
190416008
190417004
190418009
190419001
190422004
190447002
193184006
197605007
198609003
199223000
199227004
199229001
Page 8 of 34
199230006
199231005
199234002
201250006
201251005
201252003
23045005
230572002
230577008
237599002
237600004
237601000
237604008
237613005
237618001
237619009
237627000
25907005
26298008
267379000
267380002
2751001
275918005
28032008
28453007
290002008
309426007
310387003
311366001
312912001
313435000
313436004
314537004
314771006
314772004
314893005
314902007
314903002
33559001
34140002
359611005
359638003
359642000
360546002
371087003
38542009
Page 9 of 34
39058009
39181008
408539000
408540003
413183008
414890007
414906009
420414003
420422005
420491007
420738003
420989005
421223006
421389009
421443003
421750000
421847006
421895002
422155003
422183001
422228004
422275004
423263001
424736006
424989000
425159004
425442003
426705001
426875007
427089005
428896009
42954008
44054006
4627003
46635009
46894009
50620007
51002006
53126001
5368009
54181000
57886004
59079001
5969009
69878008
70694009
Page 10 of 34
71546005
73211009
74263009
75022004
75524006
75682002
76751001
81531005
81830002
8801005
91352004
9859006
Diabetes Diagnosis Names
Abnormal glucose tolerance
Abnormal maternal glucose tolerance, antepartum
Abnormal maternal glucose tolerance, complicating pregnancy, childbirth, or the puerperium, unspecified as
to episode of care
Abnormal maternal glucose tolerance, previous postpartum condition
Abnormal maternal glucose tolerance, with delivery
Abnormal maternal glucose tolerance, with delivery, with current postpartum complication
Adrenal cortical steroids
Adult-onset diabetes
Adult-onset diabetes mellitus
Background diabetic retinopathy
Brittle diabetes
Bronze diabetes
Bronzed diabetes
Carpenter syndrome
Central diabetes insipidus
Chronic painful diabetic neuropathy
complications of pregnancy, childbirth and the puerperium
Corticosteroid-induced diabetes
DI
Diabetes
Diabetes insipidus
Diabetes mellitus
diabetes mellitus AND insipidus with optic atrophy AND deafness
diabetes mellitus associated with cystic fibrosis
diabetes mellitus associated with genetic syndrome
diabetes mellitus associated with hormonal etiology
diabetes mellitus associated with pancreatic disease
diabetes mellitus associated with receptor abnormality
diabetes mellitus autosomal dominant type II
diabetes mellitus due to cystic fibrosis
diabetes mellitus due to insulin receptor antibodies
diabetes mellitus due to structurally abnormal insulin
Page 11 of 34
diabetes mellitus during pregnancy - baby not yet delivered
diabetes mellitus during pregnancy, childbirth and the puerperium
Diabetes mellitus during pregnancy, childbirth or the puerperium NOS
Diabetes mellitus in mother complicatin pregnancy, childbirth AND/OR puerperium
diabetes mellitus induced by non-steroid drugs
diabetes mellitus induced by non-steroid drugs without complication
Diabetes mellitus NOS with ketoacidosis
Diabetes mellitus NOS with neurological manifestation
Diabetes mellitus NOS with peripheral circulatory disorder
Diabetes mellitus NOS with unspecified complication
Diabetes mellitus of mother with delivery
Diabetes mellitus type 1
Diabetes mellitus type 2
diabetes mellitus type 2 in nonobese
diabetes mellitus type 2 in obese
Diabetes mellitus type I
Diabetes mellitus type II
diabetes mellitus with no mention of complication
diabetes mellitus with other specified manifestation
diabetes mellitus without complication
Diabetes mellitus without mention of complication
Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled
Diabetes mellitus without mention of complication, type I [juvenile type], uncontrolled
Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
Diabetes mellitus without mention of complication, type II or unspecified type, uncontrolled
diabetes mellitus, adult onset, with hyperosmolar coma
diabetes mellitus, adult onset, with no mention of complication
diabetes mellitus, adult onset, with other specified manifestation
diabetes mellitus, juvenile type, with hyperosmolar coma
diabetes mellitus, juvenile type, with no mention of complication
diabetes mellitus, juvenile type, with other specified manifestation
Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled
Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled
Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled
Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled
Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled
Diabetes with ketoacidosis, type I [juvenile type], uncontrolled
Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled
Diabetes with ketoacidosis, type II or unspecified type, uncontrolled
Diabetes with neurological manifestations, type I [juvenile type], not stated as uncontrolled
Diabetes with neurological manifestations, type I [juvenile type], uncontrolled
Diabetes with neurological manifestations, type II or unspecified type, not stated as uncontrolled
Diabetes with neurological manifestations, type II or unspecified type, uncontrolled
Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as uncontrolled
Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled
Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as uncontrolled
Page 12 of 34
Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled
Diabetes with other coma, type I [juvenile type], not stated as uncontrolled
Diabetes with other coma, type I [juvenile type], uncontrolled
Diabetes with other coma, type II or unspecified type, not stated as uncontrolled
Diabetes with other coma, type II or unspecified type, uncontrolled
Diabetes with other specified manifestations
Diabetes with other specified manifestations, type I [juvenile type], not stated as uncontrolled
Diabetes with other specified manifestations, type I [juvenile type], uncontrolled
Diabetes with other specified manifestations, type II or unspecified type, not stated as uncontrolled
Diabetes with other specified manifestations, type II or unspecified type, uncontrolled
Diabetes with peripheral circulatory disorders
Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as uncontrolled
Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled
Diabetes with peripheral circulatory disorders, type II or unspecified type, not stated as uncontrolled
Diabetes with peripheral circulatory disorders, type II or unspecified type, uncontrolled
Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled
Diabetes with renal manifestations, type I [juvenile type], uncontrolled
Diabetes with renal manifestations, type II or unspecified type, uncontrolled
Diabetes with unspecified complication
Diabetes with unspecified complication, type I [juvenile type], not stated as uncontrolled
Diabetes with unspecified complication, type I [juvenile type], uncontrolled
Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled
Diabetes with unspecified complication, type II or unspecified type, uncontrolled
diabetes-deafness syndrome maternally transmitted
Diabetes-nephrosis syndrome
Diabetic amyotrophy
Diabetic autonomic neuropathy
Diabetic autonomic neuropathy associated with type 1 diabetes mellitus
Diabetic autonomic neuropathy associated with type 2 diabetes mellitus
Diabetic coma with ketoacidosis
Diabetic complication
Diabetic foot ulcer
Diabetic gangrene
Diabetic gastroparesis
Diabetic gastroparesis associated with type 1 diabetes mellitus
Diabetic gastroparesis associated with type 2 diabetes mellitus
Diabetic glomerulopathy
Diabetic intracapillary glomerulosclerosis
Diabetic ketoacidosis
Diabetic macular edema
Diabetic mononeuropathy
Diabetic mononeuropathy simplex
Diabetic neuropathy
Diabetic neuropathy with neurologic complication
Diabetic optic papillopathy
Diabetic peripheral angiopathy
Page 13 of 34
Diabetic peripheral neuropathy
Diabetic radiculopathy
Diabetic renal disease
Diabetic retinopathy
Diabetic skin ulcer
DM
drug-induced diabetes mellitus
Evidence of treatment for nephropathy
fibrocalculous pancreatic diabetes
Gangrene associated with diabetes mellitus
GDM
Gestational diabetes
Gestational diabetes mellitus
gestational diabetes mellitus, class A>1<
gestational diabetes mellitus, class A>2<
gestational diabetes mellitus, class B
gestational diabetes mellitus, class B>1<
gestational diabetes mellitus, class C
gestational diabetes mellitus, class D
gestational diabetes mellitus, class F
gestational diabetes mellitus, class H
gestational diabetes mellitus, class R
gestational diabetes mellitus, class T
Growth-onset diabetes mellitus
Hemochromatosis
Houssay's syndrome
Hyperosmolality due to uncontrolled type I diabetes mellitus
hyperproinsulinemia
Hypoglycemic shock
IDD
IDDM
Immune-mediated
Impaired glucose tolerance
insulin autoimmune syndrome
Insulin coma
insulin dependent diabetes mellitus type IA
insulin dependent diabetes mellitus type IB
Insulin-dependent
insulin-dependent diabetes mellitus secretory diarrhea syndrome
insulin-resistant diabetes mellitus AND acanthosis nigricans
insulin-treated non-insulin-dependent diabetes mellitus
Ischemic ulcer diabetic foot
Juvenile diabetes mellitus
Juvenile-onset diabetes
Juvenile-onset diabetes mellitus
Ketoacidosis in type II diabetes mellitus
Page 14 of 34
Ketoacidotic coma in type II diabetes mellitus
Ketosis-prone diabetes mellitus
Kimmelstiel-Wilson syndrome
LADA
latent autoimmune diabetes mellitus in adult
Latent autoimmune diabetes of adults
malnutrition related diabetes mellitus
malnutrition-related diabetes mellitus - fibrocalculous
malnutrition-related diabetes mellitus with ketoacidosis
malnutrition-related diabetes mellitus with multiple complications
malnutrition-related diabetes mellitus with peripheral circulatory complications
malnutrition-related diabetes mellitus with renal complications
malnutrition-related diabetes mellitus without complications
Maternal diabetes mellitus with delivery, with current postpartum complication
Maternal diabetes mellitus, antepartum
Maternal diabetes mellitus, complicating pregnancy, childbirth, or the puerperium, unspecified as to episode
of care
Maternal diabetes mellitus, previous postpartum condition
maturity onset diabetes mellitus in young
Maturity-onset
Mild nonproliferative diabetic retinopathy
Mixed diabetic ulcer - foot
Moderate nonproliferative diabetic retinopathy
multiple complications of type I diabetes mellitus
multiple complications of type II diabetes mellitus
Neonatal Diabetes
Neonatal Diabetes Mellitus
Nephrogenic diabetes insipidus
Nephrotic syndrome in diabetes mellitus
Neuropathic diabetic ulcer - foot
NIDDM
NIDDM in nonobese
Nodular glomerulosclerosis
Nonclinical diabetes
Non-insulin dependent diabetes
Non–insulin-dependent diabetes mellitus
Nonproliferative diabetic retinopathy NOS
O/E - left chronic diabetic foot ulcer
O/E -right chronic diabetic foot ulcer
Other specified diabetes mellitus with coma
Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy
Other specified diabetes mellitus with nonproliferative diabetic retinopathy NOS
Other specified diabetes mellitus with proliferative diabetic retinopathy
Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy
Peripheral circulatory disorder associated with diabetes mellitus
Page 15 of 34
pineal hyperplasia AND diabetes mellitus syndrome
Poisoning by adrenal cortical steroid
Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists,
not elsewhere classified
Polycystic ovaries
Preclinical diabetes
Pre-diabetes
pre-existing diabetes mellitus, insulin-dependent
pre-existing diabetes mellitus, non-insulin-dependent
Pre-existing malnutrition-related diabetes mellitus
pregnancy and non-insulin-dependent diabetes mellitus
Proliferative diabetic retinopathy
protein-deficient diabetes mellitus
Renal diabetes
secondary diabetes mellitus
secondary endocrine diabetes mellitus
Severe nonproliferative diabetic retinopathy
Steroid induced diabetes
steroid-induced diabetes mellitus without complication
Subclinical diabetes
Type 1 d. Mellitus
Type 1 diabetes
Type 1 diabetes mellitus
Type 1 diabetes mellitus with diabetic cataract
Type 2 d. mellitus
Type 2 diabetes
Type 2 diabetes mellitus
Type 2 diabetes mellitus with diabetic cataract
Type 2 diabetes mellitus without complications
Type I diabetes
Type I diabetes mellitus
Type I diabetes mellitus - poor control
Type I diabetes mellitus maturity onset
Type I diabetes mellitus with arthropathy
Type I diabetes mellitus with gangrene
Type I diabetes mellitus with hypoglycemic coma
Type I diabetes mellitus with ulcer
Type I diabetes mellitus without complication
Type II diabetes
Type II diabetes mellitus
Type II diabetes mellitus - poor control
Type II diabetes mellitus with arthropathy
Type II diabetes mellitus with gangrene
Type II diabetes mellitus with hypoglycemic coma
Type II diabetes mellitus with peripheral angiopathy
Type II diabetes mellitus with ulcer
Page 16 of 34
Type II diabetes mellitus without complication
unspecified diabetes mellitus with multiple complications
unstable diabetes
unstable type I diabetes mellitus
Diabetes Medication Codes & Names
Diabetes Medication Codes
RxNorm Codes
105374
105374
153842
197306
197307
197495
197496
197737
198291
198292
198293
198294
199149
199150
199245
199246
199247
199825
199984
199985
200065
200132
200256
200257
200258
205314
205329
205330
205331
237527
242120
242916
242917
252960
259111
260265
283394
310488
310489
Page 17 of 34
310490
310534
310536
310537
310539
311040
311041
311053
311054
311055
311056
311057
311058
311059
311060
311061
311919
312440
312441
312859
312860
312861
313418
313419
314000
314006
314038
314142
315107
315239
317573
317800
351297
358349
379804
389137
389139
401938
484322
485210
544614
602544
602549
602550
647237
647239
Page 18 of 34
665033
665038
665042
706895
706896
744863
757710
757712
763002
763007
763013
763014
833159
844809
844824
844827
847191
847207
847211
847230
847239
847252
847259
847263
847416
847910
847915
860975
860978
860981
860984
860996
860999
861004
861007
861010
861021
861025
861035
861039
861042
861044
861731
861736
861740
861743
Page 19 of 34
861748
861753
861760
861763
861769
861783
861787
861790
861795
861806
861816
861819
861822
NDC Codes
00002751001
00002751101
00002751201
00002751601
00002821501
00002831501
00002850101
00002871501
2872501
2873001
2877001
2879301
2879401
2879701
2879901
2951501
3421411
6011201
6057561
7314813
7316318
9007002
9013101
9034101
9501201
26286148
26286151
26286251
26286351
29315818
39005110
39022110
Page 20 of 34
49155066
49411066
54014025
54014120
54014125
54014225
69005019
69005053
69005085
69070737
69393066
78035105
87607211
87607731
88221905
88222033
88222052
88250033
88250052
88250205
115115001
115115002
115115101
115115102
115115201
115115202
169001771
169004571
169008181
169009201
169183311
169183317
169183417
169183711
169231321
169231421
169231721
169330312
169368213
169368512
169368712
169369619
169406012
169633910
169643910
169750111
Page 21 of 34
172224580
247192430
247192530
247192630
555044202
555044302
12280006030
13411010103
13411010203
13411010303
16252052301
16252052401
16252052501
21695014715
21695014815
35356013060
49999045030
49999045130
50419086148
50419086151
50419086251
50419086351
51641040501
54569450100
54569606100
54868382301
54868538200
54868538400
54868550000
54868550001
54868555300
54868555301
54868583100
54868583101
54868594500
55289017142
59060183302
59060183402
59060183702
59060231704
64764015518
64764015560
64764015818
64764015860
64764030230
64764031030
Page 22 of 34
64764051030
66780011502
66780012102
Diabetes Medication Names
Diabetes Medication Brand Names
Acarbose
60 ACTUAT exenatide 0.01 MG/ACTUAT Prefilled Syringe
Acarbose 100 MG Oral Tablet
Acarbose 25 MG Oral Tablet
Acarbose 50 MG Oral Tablet
Acarbose
Acetohexamide
Actoplus met 15 MG Oral Tablet
Actoplus met XR 15 MG Oral Tablet
Actoplus Met XR
Actoplus Met
Actos 15 MG Oral Tablet
Actos
Amaryl
Apidra OptiClik Cartridge
Apidra SoloStar Pen
Apidra
Avandamet
Avandaryl
Avandia
Byetta Prefilled Pen
Chlorpropamide
DiaBeta
Diabinese
Duetact
Exenatide
Exubera Combination Pack 12
Exubera Combination Pack 15
Exubera Kit
Exubera
Gliclazide 30 MG Extended Release Tablet
Gliclazide 80 MG Oral Tablet
Gliclazide
glimepiride
glipizide ER
glipizide
glipizide/metformin hydrochloride
Glucotrol XL
Glucotrol
Glucovance
glyburide
Page 23 of 34
Glynase PresTab
Glyset
Humalog Cartridge
Humalog KwikPen
Humalog Mix 50/50 Pen
Humalog Mix 50/50
Humalog Mix 75/25 KwikPen
Humalog Mix 75/25 Pen
Humalog Mix 75/25
Humalog Pen
Humalog
Humulin 50/50
Humulin 70/30 Pen
Humulin 70/30
Humulin N Pen
Humulin N
Humulin R (Concentrated)
Humulin R
insulin Glargine
insulin Lispro
insulin
insulin, Aspart Protamine, Human
insulin, Aspart, Human
insulin, Glulisine, Human
insulin, Prompt Zinc, Beef
insulin, Prompt Zinc, Beef-Pork
insulin, Prompt Zinc, Pork
insulin, Protamine Zinc, Beef-Pork
insulin, Protamine Zinc, Pork
insulin, Regular, Beef
insulin, Regular, Beef-Pork
insulin, Regular, Pork
insulin, Zinc, Human
insulin, Zinc, Pork
Janumet
Januvia
Lantus OptiClik Cartridge
Lantus Solostar Pen
Lantus
Levemir FlexPen
Levemir
Metaglip
metformin hydrochloride
metformin
Micronase
Miglitol
Page 24 of 34
Miglustat 100 MG Oral Capsule
Miglustat
Nateglinide
Novolin 70/30 Innolet
Novolin 70/30 PenFill
Novolin 70/30
Novolin N Innolet
Novolin N PenFill
Novolin N
Novolin R Innolet
Novolin R PenFill
Novolin R
NovoLog FlexPen
NovoLog Mix 70/30 FlexPen
Novolog Mix 70/30 PenFill
NovoLog Mix 70/30
NovoLog PenFill
NovoLog
Onglyza
Pioglitazone
PrandiMet
Prandin
Precose
Relion Novolin 70/30 Innolet
Relion Novolin N
ReliOn/Novolin 70/30
ReliOn/Novolin R
Repaglinide
Rosiglitazone
Sitagliptin Phosphate
Starlix
Symlin
SymlinPen 120
SymlinPen 60
tolazamide
Tolbutamide 250 MG Oral Tablet
Tolbutamide 50 MG/ML Injectable Solution
Tolbutamide 500 MG Oral Tablet
Tolbutamide
Tolbutamide
Tolinase
Tol-Tab
Victoza
Diabetes Medication Generic Names
acarbose
acetohexamide 250 MG Oral Tablet
Page 25 of 34
acetohexamide 250 mg oral tablet
acetohexamide 500 MG Oral Tablet
acetohexamide 500 mg oral tablet
acetohexamide
acetohexamide
aspart human insulin 300 UNT per 3 ML Prefilled Syringe
aspart protamine human insulin 210 UNT / aspart human insulin 90 UNT per 3 ML Prefilled Syringe
chlorpropamide 100 MG Oral Tablet
chlorpropamide 250 MG Oral Tablet
chlorpropamide
detemir insulin 300 UNT per 3 ML Prefilled Syringe
exenatide 0.25 MG/ML Injectable Solution
exenatide 10 mcg/0.04 mL subcutaneous solution
exenatide 5 mcg/0.02 mL subcutaneous solution
exenatide 5 MCG/ACTUAT Prefilled Syringe, 60 ACTUAT
exenatide
glargine insulin 300 UNT per 3 ML Prefilled Syringe
glimepiride 1 MG / rosiglitazone 4 MG Oral Tablet
glimepiride 1 MG Oral Tablet
glimepiride 2 MG / pioglitazone 30 MG Oral Tablet
glimepiride 2 MG / rosiglitazone 4 MG Oral Tablet
glimepiride 2 MG / rosiglitazone 8 MG Oral Tablet
glimepiride 2 MG Oral Tablet
glimepiride 3 MG Oral Tablet
glimepiride 4 MG / pioglitazone 30 MG Oral Tablet
glimepiride 4 MG / rosiglitazone 4 MG Oral Tablet
glimepiride 4 MG / rosiglitazone 8 MG Oral Tablet
glimepiride 4 MG Oral Tablet
glimepiride
glimepiride-pioglitazone 2 mg-30 mg oral tablet
glimepiride-pioglitazone 4 mg-30 mg oral tablet
glimepiride-rosiglitazone 1 mg-4 mg oral tablet
glimepiride-rosiglitazone 2 mg-4 mg oral tablet
glimepiride-rosiglitazone 2 mg-8 mg oral tablet
glimepiride-rosiglitazone 4 mg-4 mg oral tablet
glimepiride-rosiglitazone 4 mg-8 mg oral tablet
glipizide 10 MG Extended Release Tablet
glipizide 10 MG Oral Tablet
glipizide 10 mg oral tablet, extended release
glipizide 2.5 MG / metformin hydrochloride 250 MG Oral Tablet
glipizide 2.5 MG / metformin hydrochloride 500 MG Oral Tablet
glipizide 2.5 MG Extended Release Tablet
glipizide 2.5 MG Oral Tablet
glipizide 2.5 mg oral tablet, extended release
glipizide 5 MG / metformin hydrochloride 500 MG Oral Tablet
glipizide 5 MG Extended Release Tablet
Page 26 of 34
glipizide 5 MG Oral Tablet
glipizide 5 mg oral tablet, extended release
glipizide ER 10 MG 24 HR Extended Release Tablet
glipizide ER 2.5 MG 24 HR Extended Release Tablet
glipizide ER 5 MG 24 HR Extended Release Tablet
glipizide extended release
glipizide XL
glipizide
glipizide-metformin 2.5 mg-250 mg oral tablet
glipizide-metformin 2.5 mg-500 mg oral tablet
glipizide-metformin 5 mg-500 mg oral tablet
glipizide-metformin
gliquidone 30 MG Oral Tablet
glyburide 1.25 MG / metformin hydrochloride 250 MG Oral Tablet
glyburide 1.25 MG Oral Tablet
glyburide 1.5 MG Oral Tablet
glyburide 2.5 MG / metformin hydrochloride 500 MG Oral Tablet
glyburide 2.5 MG Oral Tablet
glyburide 3 MG Oral Tablet
glyburide 4.5 MG Oral Tablet
glyburide 5 MG / metformin hydrochloride 500 MG Oral Tablet
glyburide 5 MG Oral Tablet
glyburide 6 MG Oral Tablet
glyburide micronized 1.5 mg oral tablet
glyburide micronized 3 mg oral tablet
glyburide micronized 6 mg oral tablet
glyburide
glyburide, micronized
glyburide-metformin 1.25 mg-250 mg oral tablet
glyburide-metformin 2.5 mg-500 mg oral tablet
glyburide-metformin 5 mg-500 mg oral tablet
glyburide-metformin
insulin aspart 100 units/mL subcutaneous solution
insulin aspart-insulin aspart protamine 30 units-70 units/mL subcutaneous suspension
insulin biphasic aspart 50/50 100 UNT/ML Injectable Suspension
insulin detemir 100 units/mL subcutaneous solution
insulin detemir 100 UNT/ML Injectable Solution
insulin glargine 100 units/mL subcutaneous solution
insulin glargine 100 UNT/ML Injectable Solution
insulin glulisine 100 units/mL subcutaneous solution
insulin human, rDNA origin 1 MG/ACTUAT Inhalant Powder
insulin human, rDNA origin 3 MG/ACTUAT Inhalant Powder
insulin inhalation, rapid acting 1 mg and 3 mg inhalation powder
insulin inhalation, rapid acting 1 mg inhalation powder
insulin inhalation, rapid acting 3 mg inhalation powder
insulin isophane human recombinant 100 units/mL subcutaneous suspension
Page 27 of 34
insulin isophane-insulin regular human recombinant 50 units-50 units/mL subcutaneous suspension
insulin lispro 100 units/mL subcutaneous solution
insulin Lispro 25 UNT/ML / insulin, Protamine Lispro, Human 75 UNT/ML Injectable Suspension
insulin Lispro 50 UNT/ML / insulin, Protamine Lispro, Human 50 UNT/ML Injectable Suspension
insulin lispro-insulin lispro protamine 25 units-75 units/mL subcutaneous suspension
insulin lispro-insulin lispro protamine 50 units-50 units/mL subcutaneous suspension
insulin regular human recombinant (concentrated) 500 units/mL subcutaneous solution
insulin regular human recombinant 100 units/mL injectable solution
insulin, Aspart Protamine, Human 70 UNT/ML / insulin, Aspart, Human 30 UNT/ML Injectable Suspension
insulin, Aspart, Human 100 UNT/ML Injectable Solution
insulin, Glulisine, Human 100 UNT/ML 3 ML Prefilled Syringe
insulin, Glulisine, Human 100 UNT/ML Injectable Solution
insulin, Prompt Zinc, Beef 100 UNT/ML Injectable Suspension
insulin, Prompt Zinc, Beef-Pork 100 UNT/ML Injectable Suspension
insulin, Prompt Zinc, Beef-Pork 40 UNT/ML Injectable Suspension
insulin, Prompt Zinc, Pork 100 UNT/ML Injectable Suspension
insulin, protamine zinc, beef 100 UNT/ML Injectable Suspension
insulin, Protamine Zinc, Beef-Pork 100 UNT/ML Injectable Suspension
insulin, Protamine Zinc, Beef-Pork 40 UNT/ML Injectable Suspension
insulin, Protamine Zinc, Pork 100 UNT/ML Injectable Suspension
insulin, Regular, Beef 100 UNT/ML Injectable Solution
insulin, Regular, Beef-Pork 100 UNT/ML Injectable Solution
insulin, Regular, Beef-Pork 40 UNT/ML Inhalant Solution
insulin, Regular, Pork 100 UNT/ML Injectable Solution
insulin, Regular, Pork 30 UNT/ML / NPH insulin, Pork 70 UNT/ML Injectable Suspension
insulin, Regular, Pork 40 UNT/ML Injectable Solution
insulin, Regular, Pork 500 UNT/ML Injectable Solution
insulin, Zinc, Human 100 UNT/ML Injectable Suspension
insulin, Zinc, Pork 100 UNT/ML Injectable Suspension
insulin, Zinc, Pork 40 UNT/ML Injectable Solution
liraglutide 18 mg/3 mL subcutaneous injection
lispro insulin 150 UNT / protamine lispro human insulin 150 UNT per 3 ML Prefilled Syringe
lispro insulin 150 UNT per 1.5 ML Prefilled Syringe
lispro insulin 300 UNT per 3 ML Prefilled Syringe
lispro insulin 75 UNT / protamine lispro human insulin 225 UNT per 3 ML Prefilled Syringe
lispro PRC
metformin hydrochloride 100 MG/ML Oral Solution
metformin hydrochloride 1000 MG / rosiglitazone 2 MG Oral Tablet
metformin hydrochloride 1000 MG / rosiglitazone 4 MG Oral Tablet
metformin hydrochloride 1000 MG / sitagliptin 50 MG Oral Tablet
metformin hydrochloride 1000 MG 24 HR Extended Release Tablet
metformin hydrochloride 1000 MG Extended Release Tablet
metformin hydrochloride 1000 MG Oral Tablet
metformin hydrochloride 24 HR 500 MG Extended Release Tablet
metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet
metformin hydrochloride 500 MG / repaglinide 1 MG Oral Tablet
Page 28 of 34
metformin hydrochloride 500 MG / repaglinide 2 MG Oral Tablet
metformin hydrochloride 500 MG / rosiglitazone 1 MG Oral Tablet
metformin hydrochloride 500 MG / rosiglitazone 2 MG Oral Tablet
metformin hydrochloride 500 MG / rosiglitazone 4 MG Oral Tablet
metformin hydrochloride 500 MG / sitagliptin 50 MG Oral Tablet
metformin hydrochloride 500 MG Extended Release Tablet
metformin hydrochloride 500 MG Oral Tablet
metformin hydrochloride 625 MG Oral Tablet
metformin hydrochloride 750 MG 24 HR Extended Release Tablet
metformin hydrochloride 750 MG Extended Release Tablet
metformin hydrochloride 850 MG / pioglitazone 15 MG Oral Tablet
metformin hydrochloride 850 MG Oral Tablet
metformin
metformin-pioglitazone 1000 mg-15 mg oral tablet, extended release
metformin-pioglitazone 1000 mg-30 mg oral tablet, extended release
metformin-pioglitazone 500 mg-15 mg oral tablet
metformin-pioglitazone 850 mg-15 mg oral tablet
metformin-repaglinide 500 mg-1 mg oral tablet
metformin-rosiglitazone 1000 mg-2 mg oral tablet
metformin-rosiglitazone 1000 mg-4 mg oral tablet
metformin-rosiglitazone 500 mg-1 mg oral tablet
metformin-rosiglitazone 500 mg-2 mg oral tablet
metformin-rosiglitazone 500 mg-4 mg oral tablet
metformin-sitagliptin 1000 mg-50 mg oral tablet
metformin-sitagliptin 500 mg-50 mg oral tablet
miglitol 100 MG Oral Tablet
miglitol 25 MG Oral Tablet
miglitol 50 MG Oral Tablet
miglitol
nateglinide 120 MG Oral Tablet
nateglinide 180 MG Oral Tablet
nateglinide
pioglitazone 15 MG Oral Tablet
pioglitazone 30 MG Oral Tablet
pioglitazone 45 MG Oral Tablet
pioglitazone
pramlintide 1000 mcg/mL subcutaneous solution
pramlintide 600 mcg/mL subcutaneous solution
pramlintide acetate 0.6 MG/ML Injectable Solution
pramlintide acetate 1 MG/ML Injectable Solution
pramlintide acetate 1.5 MG per 1.5 ML Prefilled Syringe
pramlintide acetate 2.7 MG per 2.7 ML Prefilled Syringe
rDNA origin human insulin 1 MG/ACTUAT Dry Powder Inhaler, 90 ACTUAT
rDNA origin human insulin 3 MG/ACTUAT Dry Powder Inhaler, 90 ACTUAT
repaglinide 0.5 MG Oral Tablet
repaglinide 1 MG Oral Tablet
Page 29 of 34
repaglinide 2 MG Oral Tablet
repaglinide
rosiglitazone 2 MG Oral Tablet
rosiglitazone 4 MG Oral Tablet
rosiglitazone 8 MG Oral Tablet
rosiglitazone
saxagliptin 2.5 mg oral tablet
saxagliptin 5 mg oral tablet
sitagliptin 100 MG Oral Tablet
sitagliptin 25 MG Oral Tablet
sitagliptin 50 MG Oral Tablet
sitagliptin phosphate
tolazamide 100 MG Oral Tablet
tolazamide 250 MG Oral Capsule
tolazamide 250 MG Oral Tablet
tolazamide 500 MG Oral Tablet
tolazamide
tolbutamide
troglitazone 200 MG Oral Tablet
troglitazone 300 MG Oral Tablet
troglitazone 400 MG Oral Tablet
vildagliptin 100 MG Oral Tablet
vildagliptin 50 MG Oral Tablet
Diabetes Lab Test Codes & Names
Diabetes Lab Test Codes
LOINC Codes
17856-6
4548-4
4549-2
SNOMED Codes
33601001
40402000
43396009
117346004
165680008
259689004
259690008
313835008
408254005
CPT Codes
83036
83037
Diabetes Lab Test Names
A1c
Glucohemoglobin measurement
glycosylated hemoglobin A
Page 30 of 34
glycosylated hemoglobin
glycosylated hemoglobin-c fraction
HbA1c test
HbA1c
Hemoglobin A1c test
Hemoglobin A1c
total glycosylated hemoglobin level
total glycosylated hemoglobin
Encounter Codes & Names
Acute Encounter Codes & Names
Acute Encounter CPT Codes
99221
99222
99223
99231
99232
99233
99238
99239
99251
99252
99253
99254
99255
99291
99281
99282
99283
99284
99285
Acute Encoutner ICD-9-CM Codes
99221
99222
99223
99231
99232
99233
99238
99239
99251
99252
99253
99254
99255
99291
99281
Page 31 of 34
99282
99283
99284
99285
Acute Encounter Names
Acute Inpatient Care Unit
Acute Inpatient Care
Acute Inpatient Unit
Acute Inpatient
Critical Care Unit
Critical Care
ED
Emergency Department
Emergency Room
encounter acute inpt
encounter ED
encounter non-acute inpatient
encounter outpatient
Inpatient Mental Health Department
Inpatient Mental Health
Inpatient Mental Health Unit
Inpatient Substance Abuse Department
Inpatient Substance Abuse Unit
Inpatient Substance Abuse
Inpatient Surgery
Intensive Care Unit
Intensive Care
Non-Acute Encounter Codes & Names
Non-Acute Encounter CPT Codes
99304
99305
99306
99307
99308
99309
99310
99315
99316
99318
99324
99325
99326
99327
99328
99334
99335
Page 32 of 34
99336
99337
99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99217
99218
99219
99220
99241
99242
99243
99244
99245
99341
99342
99343
99344
99345
99347
99348
99349
99350
99384
99385
99386
99387
99394
99395
99396
99397
99401
99402
99403
99404
99411
99412
99420
99429
Page 33 of 34
99455
99456
Non-Acute Encounter Names
Non-Acute Inpatient
Non-Acute Inpatient Unit
Non-Acute Inpatient Care
Sub-Acute Inpatient Care Unit
Sub-Acute Inpatient Unit
Sub-Acute Inpatient Care
Sub-Acute Inpatient Care Unit
Nonacute Inpatient
Nonacute Inpatient Unit
Nonacute Inpatient Care
Subacute Inpatient Care Unit
Subacute Inpatient Unit
Subacute Inpatient Care
Subacute Inpatient Care Unit
Outpatient
Office Visit
Ophthalmology
Page 34 of 34