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Indicator Details: Percentage of Patients with a Diagnosis of Diabetes
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The overall unadjusted percentage of patients with a diabetes mellitus code (ICD-9-CM or ICD-10-CM diagnosis code) has slightly increased in the last decade, for patients aged 20 to 64 years enrolled in Clinformatics Commercial.
Chart Explanation: The chart shows on the y-axis (vertical line) the percentage of patients with a  diagnosis of diabetes. The x-axis (horizontal line) shows the age groups (block of bars) by year, gender, and race/ethnicity (individual colored bars).
The Optum Clinformatics data mart provides paid medical and prescription claims and enrollment information for participants in commercial insurance plans and Medicare Advantage plans of a large U.S. managed care health insurance company. 

CKD is defined using ICD-9-CM or ICD-10-CM diagnosis codes, and ESRD is based on ICD diagnosis, CPT procedure, and DRG codes in Optum Clinformatics.
Description of MeasurePrevalence of diagnosed diabetes (by ICD-9-CM or ICD-10-CM codes) stratified by age, race/ethnicity, gender, and hypertension diagnosis
Data SourceClinformatics Commercial™ from Optum Clinformatics data mart database (OptumInsight, Eden Prairie, MN)
Type of Data SourceAdministrative
Data SetClinformatics Commercial enrollees aged 20 to 64 years
Health Care System DataYes
Regional or NationalRegional
Demographic GroupPatient aged 20 to 64 years enrolled in commercial Clinformatics insurance.
NumeratorPatients in denominator with diagnosed diabetes from one inpatient or two outpatient claims by any of the ICD-9-CM or ICD-10-CM CKD codes
DenominatorPatient aged 20 to 64 years with a full year of enrollment in a given calendar year
Primary Data Source IndicatorDiagnosis code from inpatient and outpatient files
Primary Indicator Method of MeasurementMedical claim
Secondary (1) VariableAge in years at the end of the current calendar year
Secondary (2) VariableRace/ethnicity
Secondary (3) VariableSex/gender
Secondary (4) VariableDiabetes status determined by the presence of an ICD-9-CM or ICD-10-CM code for diabetes or diabetic complications, on at least one inpatient, outpatient or medical services claim during a given calendar year
Secondary (5) VariableHypertension status determined by the presence of an ICD-9-CM or ICD-10-CM code for hypertension on at least one inpatient, outpatient or medical services claim during a given calendar year
Period Currently Available2016
Limitations of IndicatorThe use ofan  ICD-9-CM or ICD-10-CM diagnosis code as a measure of prevalence, will underestimate the level of CKD in the general population.
Analytical ConsiderationsIn published literature, CKD is diagnosed by ICD-9-CM or ICD-10-CM codes in alternate ways (one outpatient, two or more outpatient or one inpatient claim). Care must be taken in comparisons.
ICD-9-CM Codes for CKD016.0, 095.4, 189.0,189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403, 404, 440.1, 442.1, 477.3, 572.4, 581-588, 591, 642.1, 646.2, 753.12-753.19, 753.2, 794.4
ICD-10-CM Codes 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