Question

I know there has been lots of feedback about DM23, DM24 & DM25 since upgrading to version 3.0.40.719, but I am still a little confused...

Our patients in the denominators & numerators for all of the above have decreased, since the upgrade.

I have checked with the laboratory and they are reporting on both 42W4 & 42W5, but the 42W5's all have no numeric values.

Since upgrading we have lost 5% on DM25.

Can you please clarify what I need to do?

Answer

The reduction in the both the numerator and denominator for DM25 is because prior to the upgrade, some patients were showing as Yes for DM25 due to an HbA1c entry being in their notes, dated on or after 1/2/2009 - even though they were only recently diagnosed or registered with the practice and the result was above the numerator threshold. As their HbA1c result was being counted as qualifying them for the numerator, this included them in the denominator too.

Now that the HbA1c was being properly analysed and is over the 'threshold', as they were newly-diagnosed or newly-registered, this removed them from the denominator and numerator; they now show as 'New Dx' or 'New Reg' in Contract patients for DM25 - not 'No'.

For the remaining patients who are appearing as 'No' for DM25, you have the option of

• doing another HbA1c test, in the hope that their diabetic control has improved since the last test and they then appear in the numerator;

OR

• if clinically appropriate and they are on maximum tolerated diabetes treatment, you can add an exception code to this effect (8BL2). You will need to be able to justify this for QOF assessment, as we discussed.