Proposed Data Element Query Parameters for Basic DAF over DIRECT Use Case Submitted by Stephen Beller on 7/12/14 – updated 7/30 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. With this in mind, let’s consider the differing needs for implementing data element queries for the two primary DAF over DIRECT use cases: 1. Manual queries using Simple SMTP1 point-to-point transport (the “Simple” use case) 2. Automated queries using SMTP with Full Service HISPs2 (the “Complex” use case). We’ve been focused on defining data element queries parameters for the Complex use case. I now propose a model that defines query parameters for the Simple use case. I contend that a very basic human readable query parameter structure should be adopted as a standard for the Simple use case. This proposed standard should map query parameters to HL7 CDA clinical concepts using standardized vocabularies and value sets. For maximum interoperability, however, it should be assumed that the query responder cannot rely on CDA OIDs or codes, parse XML, deal with XD* (XDS/XDR/XDM) file structures, nor utilize value sets stored only on the Web. I propose that the query parameters for the Simple use case would be stored in files that: 1. Represent the parameters in data-grid type structures, as depicted in the Appendix (rather than using XML and XD* file structures). 2. Mirror the Complex use case for patient identifiers and demographics, as well as information related to patient privacy, although representing them in the one-dimentional arrays. 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 1 2 Applicability Statement for Secure Health Transport Ibid Page 1 of 33 c. d. e. f. g. h. i. iii. Status Family history i. Relationship ii. Diagnosis iii. Age at onset Functional status i. Functional or Cognitive Finding ii. Observation iii. Observation Date iv. Condition Status Immunizations i. Vaccine ii. Date iii. Status 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 Medical equipment i. Supply/Device ii. Date supplied Payers i. Policy type / Coverage type ii. Covered party ID iii. Policy Holder Plan of care Page 2 of 33 i. Planned activity ii. Planned date j. Problems i. Condition ii. Effective Dates iii. Status 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 Page 3 of 33 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) 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 Appendix: Example of Query Parameters in Data Grid and Value Sets Structure Here’s an example of the proposed data-grid and value sets structure for storing query parameters in the Simple use case based on the rather complex NQF 0059 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 that the values sets referenced in the Data Criteria/Value column are located beneath the query parameters grid in the Diabetes-Related Value Sets section. Parameters Data 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 Patient Age End Date - Birth Date >=17 years AND: End Date - Birth Date <=74 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 Problem-Condition Status Effective Time Page 4 of 33 In Diabetes Diagnosis Codes & Names Value Set =Active <=Measurement End Date – 2 Years simultaneously to the measurement end date Exception: Active diagnosis of polycystic ovaries, gestational diabetes, or steroid induced diabetes Problem-Condition Status =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 Page 5 of 33 R73.09 E13.43 E13.33 E13.32 E13.35 E13.34 T38 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 Page 6 of 33 190419001 190422004 190447002 193184006 197605007 198609003 199223000 199227004 199229001 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 Page 7 of 33 314902007 314903002 33559001 34140002 359611005 359638003 359642000 360546002 371087003 38542009 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 Page 8 of 33 46894009 50620007 51002006 53126001 5368009 54181000 57886004 59079001 5969009 69878008 70694009 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 Page 9 of 33 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 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 Page 10 of 33 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 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 Page 11 of 33 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 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 Page 12 of 33 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 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 Page 13 of 33 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 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 Page 14 of 33 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 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 Page 15 of 33 200065 200132 200256 200257 200258 205314 205329 205330 205331 237527 242120 242916 242917 252960 259111 260265 283394 310488 310489 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 Page 16 of 33 314038 314142 315107 315239 317573 317800 351297 358349 379804 389137 389139 401938 484322 485210 544614 602544 602549 602550 647237 647239 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 Page 17 of 33 847910 847915 860975 860978 860981 860984 860996 860999 861004 861007 861010 861021 861025 861035 861039 861042 861044 861731 861736 861740 861743 861748 861753 861760 861763 861769 861783 861787 861790 861795 861806 861816 861819 861822 NDC Codes 00002751001 00002751101 00002751201 00002751601 00002821501 00002831501 00002850101 00002871501 2872501 Page 18 of 33 2873001 2877001 2879301 2879401 2879701 2879901 2951501 3421411 6011201 6057561 7314813 7316318 9007002 9013101 9034101 9501201 26286148 26286151 26286251 26286351 29315818 39005110 39022110 49155066 49411066 54014025 54014120 54014125 54014225 69005019 69005053 69005085 69070737 69393066 78035105 87607211 87607731 88221905 88222033 88222052 88250033 88250052 88250205 115115001 115115002 Page 19 of 33 115115101 115115102 115115201 115115202 169001771 169004571 169008181 169009201 169183311 169183317 169183417 169183711 169231321 169231421 169231721 169330312 169368213 169368512 169368712 169369619 169406012 169633910 169643910 169750111 172224580 247192430 247192530 247192630 555044202 555044302 12280006030 13411010103 13411010203 13411010303 16252052301 16252052401 16252052501 21695014715 21695014815 35356013060 49999045030 49999045130 50419086148 50419086151 50419086251 Page 20 of 33 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 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 Page 21 of 33 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 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 Page 22 of 33 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 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 Page 23 of 33 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 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 Page 24 of 33 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 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 Page 25 of 33 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 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 Page 26 of 33 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 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 Page 27 of 33 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 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 Page 28 of 33 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 glycosylated hemoglobin glycosylated hemoglobin-c fraction HbA1c test HbA1c Hemoglobin A1c test Hemoglobin A1c total glycosylated hemoglobin level total glycosylated hemoglobin Encounter Codes & Names Page 29 of 33 Acute Encounter Codes & Names Acute Encoutner 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 99282 99283 99284 99285 Acute Encounter Names Acute Inpatient Care Unit Acute Inpatient Care Page 30 of 33 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 99336 99337 99201 99202 99203 Page 31 of 33 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 99455 99456 Non-Acute Encounter Names Page 32 of 33 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 33 of 33