HEDIS® Tip Sheet

Kidney Health Evaluation for Patients With Diabetes (KED)

Measure Description

Percentage of members 18–85 years of age with diabetes (type 1 or type 2) who received a kidney health evaluation, defined by an estimated glomerular filtration rate (eGFR) and a urine albumin-creatinine ratio (uACR), during the measurement year.

Compliance

Members who received both an eGFR and a uACR during the measurement year.  These tests can be performed on the same or different dates of service.

Icon of a notebook

Notes

  • A uACR can be identified by either of the following:
    • Both a quantitative urine albumin test and a urine creatinine test with services dates no more than four days apart.
    • A uACR lab test.
  • Members with diabetes are identified by claims/encounter data and by pharmacy data.
Icon of a check mark and a document with a person

Best Practices

  • Use each office visit as a time to review services needed.
  • Prepare for office visits by ordering labs ahead of time.
  • Provide patient education about the importance of regular kidney health screenings.
  • Inform patients of the North Dakota Diabetes Prevention and Control Program resource.
  • Consider referral to diabetic educator or nutritionist. 
  • Care coordination with other providers caring for the patient.
  • Set up a tracking mechanism within your healthcare system to identify gaps in care. Utilize EHR flags and reporting to assist in tracking patients in need of follow-up visits and those who cancel or do not show up for appointments so appropriate outreach can be made.
Icon of a document with a red letter X in the bottom right

Exclusions

  • Members diagnosed with End-Stage Renal Disease (ESRD) or who had dialysis any time in the member’s history.
  • Members in hospice during the measurement year.
  • Members receiving palliative care or who had an encounter for palliative care during the measurement year.
  • Members who die any time during the measurement period.
  • Members 66-80 years of age as of December 31st of the measurement year with frailty and advanced illness.
  • Note: Members must meet BOTH the frailty and advanced illness criteria to be excluded:
    • 1. Frailty: At least two indicators of frailty with different dates of service during the measurement year.
    • 2. Advanced Illness: Either of the following during the measurement year or the year prior to the measurement year:
      • Diagnosis of advanced illness on at least two different dates of service. 
      • A dispensed dementia medication including Cholinesterase inhibitors (Donepezil, Galantamine, Rivastigmine), memantine, and Donepezil-memantine.
  • Members 81+ years of age as of December 31st of the measurement year with at least two indications of frailty on different dates of service during the measurement year. 

Coding and Benefits Disclaimer

Providers and organizations must submit accurate and complete data in accordance with all billing, coding, and medical policy requirements. HEDIS guidance does not override official coding standards or guarantee reimbursement, as coverage is subject to applicable medical/coding policy and member-specific benefits.

Questions

Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.

NCQA Copyright Notice and Disclaimer
The HEDIS® measures and specifications were developed by and are owned by NCQA. The HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures and specifications. NCQA holds a copyright in these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than NCQA. Use of the Rules for Allowable Adjustments of HEDIS to make permitted adjustments of the materials does not constitute a modification. Any commercial use and/or internal or external reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA. Any use of the materials to identify records or calculate measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program. Reprinted with permission by NCQA. © [2025] NCQA, all rights reserved.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Updated 8/28/2026