Medicare Star Ratings: More ICD-10 codes added to exclusion list for SUPD measure

The Centers for Medicare & Medicaid Services has revised its Medicare Star Ratings measure known as Statin Use in Persons with Diabetes, or SUPD.

In the past, only patients in hospice or on dialysis could be excluded from the measure. Now, in addition to those two conditions, several other ICD-10 codes have been added to the exclusion list. These codes must be billed every year.

About the SUPD measure
The SUPD measure is defined as the percent of Medicare Part D patients age 40 to 75 who:

• Received at least two diabetes medication fills during the calendar year
• Also received a statin medication fill during the calendar year

Only statin claims billed through a patient’s Part D plan count toward closing gaps in the measure. The following types of statin claims won’t close a gap in the SUPD measure:

• Claims filled through drug discount cards or store pharmacy discount programs
• Cash claims
• Medication samples
• Fills from Veterans Affairs facilities
• Fills billed to a non-Medicare insurance plan

To satisfy the SUPD measure requirements, a statin claim must be filled no later than the month before the patient turns 76. Patients born in 1945 are turning 76 years old this year.

If statin therapy isn’t medically appropriate for your patients who have diabetes, make sure the proper ICD-10 code is billed to exclude them from the SUPD measure.

Diagnosis codes added
Here are the diagnoses codes added to the SUPD exclusion list: