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Indicator Details: Percentage of Patients with a Diagnosis of Diabetes
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The prevalence of diagnosed diabetes in the Medicare system is high, at about one-quarter to one-third. 
Chart Explanation: The chart shows on the y-axis (vertical line) the percentage of patients with diagnosis of diabetes. The x-axis (horizontal line) shows the age groups (the block of bars) by year, gender, or race/ethnicity (the individual colored bars).
Data are from the Medicare 5% Sample Limited Data Sets (LDS) for Inpatient, Outpatient, and Carrier (formerly known as Physician/Supplier Part B file) claims.

Diagnoses for medical conditions within Medicare data come from claims submitted by providers for the fee-for-service sections of Medicare, Part A (hospital care) and Part B (ambulatory care). We restrict our analysis sample to beneficiaries aged 65 years or older who have Parts A and B coverage for the entire calendar year and have at least 1 outpatient visit in the calendar year. Between 20% and 25% of beneficiaries each year used Part C, managed care/Medicare Advantage plans, and are excluded since their care was paid on a capitated basis and claims with diagnoses are not available.
FieldData
Description of MeasurePrevalence of clinically diagnosed diabetes mellitus (by ICD-9-CM or ICD-10-CM codes)
Data SourceCenters for Medicare and Medicaid Services
Type of Data SourceAdministrative
Data SetMedicare National 5% Sample
Health Care System DataYes
Regional or National?National
Demographic GroupPatients aged 65 and older using fee-for-service Medicare
NumeratorPatients in denominator with diagnosed diabetes from an outpatient, inpatient or carrier claim.
DenominatorPatients aged 65 or older with full-year Part A and B enrollment and at least one outpatient visit in the calendar year, within the specified age and gender group.
Primary Data Source IndicatorDiabetes status determined by the presence of an ICD-9-CM code (250.x, 357.2, 362.01, 362.02 or 366.41) or ICD-10-CM code (E08.3xx, E08.4xx, E09.3xx, E09.4xx, E10.xxx,  E11.xxx, E13.0x, E13.1x, E13.2x, E13.3xx, E13.4x, E13.5x, E13.6xx, E13.8, E13.9) for diabetes or diabetic complications  on at least one inpatient, outpatient or carrier claim during the given calendar year.
Primary Indicator Method of MeasurementDiagnoses from inpatient, outpatient, and carrier claims.
Secondary (1) VariableAge at the end of the previous calendar year
Secondary (2) VariableSex/gender
Period Currently Available

2005–2019

Analytical ConsiderationsIn published literature, disease is diagnosed by ICD-9-CM or ICD-10-CM codes in alternate ways (one outpatient; two or more outpatient or one inpatient; differences in sample). Care must be taken in comparisons.
Limitations of IndicatorAs a measure of prevalence, the use of ICD-9-CM or ICD-10-CM diagnosis codes will underestimate the level of chronic kidney disease in the general population.
ICD-10-CM Code for CKDA18.11, A52.75, B52.0, C64.x, C68.9, D30.0x, D41.0x-D41.2x, D59.3, E08.2x, E09.2x, E10.2x, E10.65, E11.2x, E11.65, E13.2x, E74.8, I12.xx, I13.0, I13.1x, I13.2, K76.7, M10.3x, M32.14, M32.15, N01.x-N08.x, N13.1, N13.1x-N13.39, N14.x,N15.0, N15.8, N15.9, N16, N17.x, N18.1-N18.5, N18.8, N18.9, N19, N25.xx, N26.1, N26.9, O10.4xx, O12.xx, O26.83x, O90.89, Q61.02, Q61.1x-Q61.8, Q26.0-Q26.39, R94.4

Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd