COORDINATED

Dental-medical coordination

Medical to dental referrals [SYSTEM LEVEL ONLY]

Percentage of adults aged 18-75 years who have diabetes, and received at least one comprehensive, periodic or periodontal oral evaluation service during the measurement period Numerator: Members who received a comprehensive, periodic or periodontal oral evaluation CDT codes D0120 or D0150 or D0180 Denominator: Members aged 18-75 years who have diabetes, as identified in claim and pharmacy data during the measurement year or the year before the measurement period, using any one of these criteria: - At least two outpatient visits, observation visits or ED visits on different dates of service with a diagnosis of diabetes. - At least one acute inpatient encounter with a diagnosis of diabetes. - Dispensed insulin or hypoglycemics/antihyperglycemics on an ambulatory basis. Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator; patients with a diagnosis of secondary diabetes due to another condition should not be included.

Measure

Adults

Program/Plan

Administrative enrollment and claims data

CMS Quality Rating System

Used by the Oregon Health Authority for evaluation in CCOs