Primary Care (PC) Service JAWDA Performance Indicators

Primary Care (PC)

Service Jawda Guidance
Version 8
 Primary Care (PC) Service JAWDA Performance Indicators

Table of Contents
About this Guidance............................................................................................................................ 4
Percentage of patients diagnosed with depression after positive screening. ..................................... 6
Percentage of patients diagnosed with depression that have Follow-Up visit with their physicians
within 30 days of diagnosis. ................................................................................................................... 8
Diabetes: Hemoglobin A1c (HbA1c) Poor Control Rate (> 9%) or no test result.................................. 9
Diabetes: Hemoglobin A1c (HbA1c) Good Control Rate (≤7.0%)........................................................ 11
Percentage of Diabetics Receiving Annual Foot Exams ...................................................................... 13
Percentage of Diabetics Receiving Annual Eye Exams ........................................................................ 15
Percentage of Diabetics Receiving Annual Nephropathy Exams ........................................................ 17
Percentage of Patients with Controlled Hypertension (<130/80 mmHg) .......................................... 19
Percentage of Hypertensive Patients Receiving Annual Nephropathy Exams .................................. 21
Autism Screening in children between 18 to 24 months .................................................................... 23
Percentage of Patients with Poorly Controlled Hypertension (>130 mmHg or 80 mmHg) ............... 25
Percentage of high-risk patients (18 years and above) who are screened for dyslipidemia............. 27
Percentage of adult patients (18 years and above) who are overweight or obese ........................... 29
Primary Care Depression Treatment Success Rate ............................................................................. 30
APPENDIX – A ICD-10 CM CODES (O00- O9A) ....................................................................................... 31
Appendix B – ICD-10 CM CODES (E10. E11, E13, O24 Series) ............................................................... 38
Summary of Changes 2025 ................................................................................................................... 39

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 Primary Care (PC) Service JAWDA Performance Indicators

Executive Summary
The Department of Health– Abu Dhabi (DOH) is the regulatory body of the healthcare
sector in the Emirate of Abu Dhabi and ensures excellence in healthcare for the
community by monitoring the health status of its population.

The Emirate of Abu Dhabi is experiencing a substantial growth in the number of

hospitals, centers and clinics. This is ranging from school clinics and mobile units to
internationally renowned specialist and tertiary academic centers. Although, access and
quality of care has improved dramatically over the last couple of decades, mirroring the
economic upturn and population boom of Emirate of Abu Dhabi, however challenges
remain in addressing further improvements.

The main challenges that are presented with increasingly dynamic population include
an aging population with increased expectation for treatment, utilization of technology
and diverse workforce leading to increased complexity of healthcare provision in Abu
Dhabi. All of this results in an increased and inherent risk to quality and patient safety.

DOH has developed dynamic and comprehensive quality framework in order to bring
about improvements across the health sector. This guidance relates to the quality
indicators that DOH is mandating be collected and monitor by all Primary healthcare
provider in Abu Dhabi.

The guidance sets out the full definition and method of calculation for patient safety and
clinical effectiveness indicators. For enquiries about this guidance, please contact
[email protected]

This document is subjected for review and therefore it is advisable to utilize online
versions available on the DOH at all times.

Issued: Version 1 January 2021

Published Updates Version 2: January 2022
Version 3: July 2022
Version 4: Oct 2022
Version 5: Dec 2022
Version 6: January 2023
Version 7: July 2023
Version 8: January 2025

Effective from: Version 8: Q1 2025

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 Primary Care (PC) Service JAWDA Performance Indicators

About this Guidance

The guidance sets out the definitions and reporting frequency of JAWDA Primary Care
(PC) performance indicators. The Department of Health (DoH), with consultation from
local and international expertise of chronic disease management has developed Primary
Care facilities performance Indicators that are aimed for assessing the degree to which a
provider competently and safely delivers the appropriate clinical services to the patient
within the optimal period of time.

The Jawda KPI for primary care in this guidance include measures to monitor i.e. how
well primary care service providers care for their patients, how often they follow best
practices and how effective they are at keeping patients healthy, and how patients feel
about their experience at primary care service providers. Healthcare providers are the
most qualified professionals to develop and evaluate quality of care for people with
chronic conditions; therefore, it is crucial that clinicians retain a leadership position in
defining performance among primary care healthcare service providers.

Who is this guidance for?

All healthcare facilities who are licensed by DoH as Primary healthcare service provider
or who are providing Primary care Services as part of their portfolio in the Emirate of
Abu Dhabi.

All the Jawda KPIs are applicable to patient encounters* with the family medicine
consultant or general practitioner. This is in alignment with the DOH primary care
standard.

*The KPI definitions are not applicable to other specialty physician encounters e.g. pediatrician,
dental, homeopathic etc.

For further details, kindly refer to the following available at

https://www.doh.gov.ae/en/resources/standards and
https://www.doh.gov.ae/en/resources/guidelines

- DOH Standard for Primary Healthcare Services in Emirate of Abu Dhabi (September 2022)
- Scope of Practice Guidelines for Licensed Healthcare Professionals (Family Medicine) (July
2022)
- Scope of Practice for General Practitioner (October 2022)

How do I follow this guidance?

Each provider will nominate one member of staff to coordinate, collect and monitor
primary care quality indicators. Primary care provider is required to submit quarterly
submission of data through Jawda e-notification system.

Note: Jawda team may use centrally collected claim data submitted by healthcare
providers through Shafafiya portal to validate the data submitted by the providers
through Jawda portal.

What is the Regulation related to this guidance?

• Legislation establishing the Health Sector

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 Primary Care (PC) Service JAWDA Performance Indicators

• Department of Health Standard for primary care issued March 2020

https://www.doh.gov.ae/en/resources/standards
• As per DoH Policy for Quality and Patient Safety issued January 15th 2017, this
guidance applies to all DoH Licensed Hospital Healthcare Facilities in the Emirate of
Abu Dhabi in accordance with the requirements set out in this Standard.

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: Mental Health Number: PC004

KPI
Description Percentage of patients diagnosed with depression after positive
(title): screening.
Domain Effectiveness
Indicator Type Process
Definition Percentage of patients aged 18 years and older at the beginning of the
reporting quarter among all with positive PHQ2 who had a positive PHQ-9
within 24 hours.
Calculation Numerator:
Total number of unique patients from the denominator who had a positive
PHQ-9 >=5 within 24 hours.

Denominator:
All patients aged 18 (completed) age in years and older at the beginning of
the reporting quarter with positive PHQ2.

Denominator Guidance:
• The intent of the measure is to screen for depression in patients who
have never had a diagnosis of depression or bipolar disorder prior to the
eligible encounter used to evaluate the numerator.
• In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g. ABM
mandate encounters excluded)

Denominator Exclusions:
o Documentation stating the patient has an active diagnosis of
depression or has a diagnosed bipolar disorder, therefore screening or
follow-up is not required
o Patients who had an established diagnosis of depression prior to the
index encounter in the reporting quarter:
F01.51, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5,
F32.89, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8,
F33.9, F34.1, F34.81, F34.89, F43.21, F43.23, F53, O90.6, O99.340,
O99.341, O99.342, O99.343, O99.344, O99.345
o Patients who had an established diagnosis of bipolar disorder prior to
the index encounter in the reporting quarter:
F31.10, F31.11, F31.12, F31.13, F31.2, F31.30, F31.31, F31.32, F31.4,
F31.5, F31.60, F31.61, F31.62, F31.63, F31.64, F31.70, F31.71, F31.72,
F31.73, F31.74, F31.75, F31.76, F31.77, F31.78, F31.81, F31.89, F31.9
o Patients with a Documented Reason for not Screening for Depression
(Patient refuses to participate)
o Individuals who do not qualify for insurance benefits
o Documentation of medical reason for not screening patient for
depression (e.g., cognitive, functional, or motivational limitations that
may impact accuracy of results; patient is in an urgent or emergent

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 Primary Care (PC) Service JAWDA Performance Indicators

situation where time is of the essence and to delay treatment would

jeopardize the patient’s health status)
o All ABM Mandate encounters
o Individuals receiving Dental, Ayurvedic, Homeopathic Services
o Patients not assessed for vitals during the visit.
Reporting Quarterly
Frequency
Unit Measure % depression screening
International Quality ID #134: Preventive Care and Screening: Screening for Depression and Follow-Up
comparison if Plan (cms.gov)
available
Desire 90%
Direction
Data Source • Centrally collected claim data (KEH))
• Patient medical record

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: Disease management Number: PC005

KPI
Description Percentage of patients diagnosed with depression that have Follow-Up
(title): visit with their physicians within 30 days of diagnosis.
Domain Effectiveness
Indicator Type Process
Definition The percentage of mental health patients who are managed in primary care
and have a follow-up visit within 30 days of positive depression diagnosis.
Calculation Numerator: Total number of unique patients from the denominator who had
a first follow-up visit within 30 days of diagnosis.

Denominator:
Total number of unique patients aged ≥18 years of age (at the time of
depression screening and diagnosed with depression) who was positive (5-14
PHQ-9 score) for depression screening and diagnosed with depression during
the reporting quarter, within the same primary care unit/facility.

o ICD-10 CM code of depression:

F01.51, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5,
F32.89, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42,
F33.8, F33.9, F34.1, F34.81, F34.89, F43.21, F43.23, F53, O90.6,
O99.340, O99.341, O99.342, O99.343, O99.344, O99.345
o ICD-10 CM code of bipolar disorder:
F31.10, F31.11, F31.12, F31.13, F31.2, F31.30, F31.31, F31.32, F31.4,
F31.5, F31.60, F31.61, F31.62, F31.63, F31.64, F31.70, F31.71, F31.72,
F31.73, F31.74, F31.75, F31.76, F31.77, F31.78, F31.81, F31.89, F31.9

Denominator Exclusions:
• Individuals who do not qualify for insurance benefits.
• Patients with PHQ9 >=15 are expected to refer to Psychiatry
• Established depression patients who are diagnosed in another
healthcare facility prior.
Reporting Quarterly
Frequency
Unit Measure % Follow up Depression screening
International
comparison if Mental health care Standard
available
Desired >90%
Direction
Data Source • Patient medical record
• Centrally collected claim data (KEH))

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: Chronic disease management Number: PC009

KPI
Description Diabetes: Hemoglobin A1c (HbA1c) Poor Control Rate (> 9%) or no test
(title): result
Domain Effectiveness
Indicator Type Outcome
Definition Percentage of diabetics ≥18 to ≤75 years of age whose most recent HbA1c
level was >9.0% (poor control) or who had no test result within 12 months
(prior to the end of reporting quarter)

Calculation Numerator
Patients in the denominator population whose most recent HbA1c level was
> 9.0 % OR who had no test result can be performed in the same or different
facility within 12 months (prior to the end of reporting quarter)

HbA1C – CPT – 83036 (Based on LOINC observation)

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Denominator
Total number of unique patients (≥18 to ≤75 years of age), with diabetes
related outpatient visit/s during the reporting quarter

AND

who had at least 2 diabetes related outpatient visits within 09 months, by the
same primary care unit/facility (prior to the reporting quarter)

Denominator Guidance
o Diabetes related outpatient visit is face-to-face visits with primary or
secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213,
99214, 99215 plus ICD 10 Codes: E10, E11, E13, O24 series (See
Appendix – B)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g. ABM
mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is NOT
considered a separate visit.

Denominator exclusions
o Patient with diagnosis of polycystic ovaries, gestational diabetes, or
steroid-induced diabetes (within the denominator time frame)

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 Primary Care (PC) Service JAWDA Performance Indicators

ICD 10 Codes: Gestational Diabetes: O24.410, O24.414, O24.415,

O24.419, O24.420, O24.424, O24.425, O24.429, O24.430, O24.434,
O24.435, O24.439.
Polycystic Ovaries: E28.2
STERIOD INDUCED DIABETES: E09.00, E09.01, E09.10, E09.11,
E09.21, E09.22, E09.29, E09.311, E09.319, E09.3211, E09.3212,
E09.3213, E09.3219, E09.3291, E09.3292, E09.3293, E09.3299,
E09.3311, E09.3312, E09.3313, E09.3319, E09.3391, E09.3392,
E09.3393, E09.3399, E09.3411, E09.3412, E09.3413, E09.3419,
E09.3491, E09.3492, E09.3493, E09.3499, E09.3511, E09.3512,
E09.3513, E09.3519, E09.3521, E09.3522, E09.3523, E09.3529,
E09.3531, E09.3532, E09.3533, E09.3539, E09.3541, E09.3542,
E09.3543, E09.3549, E09.3551, E09.3552, E09.3553, E09.3559,
E09.3591, E09.3592, E09.3593, E09.3599, E09.36, E09.37X1,
E09.37X2, E09.37X3, E09.37X9, E09.39, E09.40, E09.41, E09.42,
E09.43, E09.44, E09.49, E09.51, E09.52, E09.59, E09.610, E09.618,
E09.620, E09.621, E09.622, E09.628, E09.630, E09.638, E09.641,
E09.649, E09.65, E09.69, E09.8, E09.9.
o All ABM Mandate encounters

Reporting Quarterly
Frequency
Unit Measure % Hemoglobin A1c >9.0 or no test result
Desired <30%
Direction
International Quality Measures | CMS
comparison if https://www.ncqa.org/hedis/measures/
available https://www.ahrq.gov/
https://www.qualityforum.org/QPS/QPSTool
Data Source • Centrally collected claim data (KEH))
• Patient medical record

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: chronic disease management Number: PC010

KPI Description
(title): Diabetes: Hemoglobin A1c (HbA1c) Good Control Rate (≤7.0%)
Domain Effectiveness
Indicator Type Outcome
Definition Percentage of diabetics ≥18 to ≤75 years of age whose most recent HbA1c
level was ≤7.0% (good control) within 12 months (prior to the end of
reporting quarter)
Calculation Numerator
Patients in the denominator population whose most recent HbA1c level was
≤7.0% can be performed in the same or different facility within 12 months
(prior to the end of reporting quarter)

HbA1C – CPT – 83036 (Based on LOINC observation)

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Denominator
Total number of unique patients (≥18 to ≤75 years of age), with diabetes
related outpatient visit/s during the reporting quarter

AND

who had at least 2 diabetes related outpatient visits within 09 months, by

the same primary care unit/facility (prior to the reporting quarter)

Denominator Guidance
o Diabetes related outpatient visit is face-to-face visits with primary or
secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213,
99214, 99215, plus ICD 10 Codes: E10, E11, E13, O24 series (See
Appendix – B)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g. ABM
mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is NOT
considered a separate visit.

Denominator Exclusions
• Patient with diagnosis of polycystic ovaries, gestational diabetes, or
steroid-induced diabetes (within the denominator time frame)
ICD 10 Codes: Gestational Diabetes: O24.410, O24.414, O24.415,
O24.419, O24.420, O24.424, O24.425, O24.429, O24.430,
O24.434, O24.435, O24.439.
Polycystic Ovaries: E28.2

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 Primary Care (PC) Service JAWDA Performance Indicators

STERIOD INDUCED DIABETES: E09.00, E09.01, E09.10, E09.11,

E09.21, E09.22, E09.29, E09.311, E09.319, E09.3211, E09.3212,
E09.3213, E09.3219, E09.3291, E09.3292, E09.3293, E09.3299,
E09.3311, E09.3312, E09.3313, E09.3319, E09.3391, E09.3392,
E09.3393, E09.3399, E09.3411, E09.3412, E09.3413, E09.3419,
E09.3491, E09.3492, E09.3493, E09.3499, E09.3511, E09.3512,
E09.3513, E09.3519, E09.3521, E09.3522, E09.3523, E09.3529,
E09.3531, E09.3532, E09.3533, E09.3539, E09.3541, E09.3542,
E09.3543, E09.3549, E09.3551, E09.3552, E09.3553, E09.3559,
E09.3591, E09.3592, E09.3593, E09.3599, E09.36, E09.37X1,
E09.37X2, E09.37X3, E09.37X9, E09.39, E09.40, E09.41, E09.42,
E09.43, E09.44, E09.49, E09.51, E09.52, E09.59, E09.610,
E09.618, E09.620, E09.621, E09.622, E09.628, E09.630, E09.638,
E09.641, E09.649, E09.65, E09.69, E09.8, E09.9.

o All ABM Mandate encounters

Reporting Quarterly
Frequency
Unit Measure % Hemoglobin A1C ≤7.0%

Desired >36%
Direction
International https://www.ncqa.org/hedis/measures/
comparison if https://www.ahrq.gov/
available https://www.qualityforum.org/QPS/QPSTool
Data Source • Centrally collected claim data (KEH)
• Patient medical record

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: chronic disease management Number: PC011

KPI Description
(title): Percentage of Diabetics Receiving Annual Foot Exams

Domain Effectiveness
Indicator Type Process
Definition Percentage of diabetics ≥18 to ≤75 years of age who received a Foot
exam: visual inspection with either a sensory exam or a pulse exam
within 12 months (prior to the end of reporting quarter)
Calculation Numerator
Patients in the denominator population with a diabetic foot exam done
(skin, soft tissue, musculoskeletal, vascular, neurological) can be
performed in the same facility within 12 months (prior to the end of
reporting quarter)

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Denominator
Total number of unique patients (≥18 to ≤75 years of age,) with diabetes
related outpatient visit/s during the reporting quarter

AND

who had at least 2 diabetes related outpatient visits within 09 months, by

the same primary care unit/facility (prior to the reporting quarter)

Denominator Guidance
o Diabetes related outpatient visit is face-to-face visits with primary
or secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212,
99213, 99214, 99215, plus ICD 10 Codes: E10, E11, E13, O24 series
(See Appendix – B)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g.
ABM mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is
NOT considered a separate visit.

Denominator Exclusions
o Patient with diagnosis of polycystic ovaries, gestational diabetes,
or steroid-induced diabetes, amputated lower limb before or
during the measurement period. (within the denominator time
frame)

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 Primary Care (PC) Service JAWDA Performance Indicators

ICD 10 Codes: Gestational Diabetes: O24.410, O24.414,

O24.415, O24.419, O24.420, O24.424, O24.425, O24.429,
O24.430, O24.434, O24.435, O24.439.
Polycystic Ovaries: E28.2
STERIOD INDUCED DIABETES: E09.00, E09.01, E09.10, E09.11,
E09.21, E09.22, E09.29, E09.311, E09.319, E09.3211,
E09.3212, E09.3213, E09.3219, E09.3291, E09.3292,
E09.3293, E09.3299, E09.3311, E09.3312, E09.3313,
E09.3319, E09.3391, E09.3392, E09.3393, E09.3399,
E09.3411, E09.3412, E09.3413, E09.3419, E09.3491,
E09.3492, E09.3493, E09.3499, E09.3511, E09.3512,
E09.3513, E09.3519, E09.3521, E09.3522, E09.3523,
E09.3529, E09.3531, E09.3532, E09.3533, E09.3539,
E09.3541, E09.3542, E09.3543, E09.3549, E09.3551,
E09.3552, E09.3553, E09.3559, E09.3591, E09.3592,
E09.3593, E09.3599, E09.36, E09.37X1, E09.37X2, E09.37X3,
E09.37X9, E09.39, E09.40, E09.41, E09.42, E09.43, E09.44,
E09.49, E09.51, E09.52, E09.59, E09.610, E09.618, E09.620,
E09.621, E09.622, E09.628, E09.630, E09.638, E09.641,
E09.649, E09.65, E09.69, E09.8, E09.9.
AMPUTATED LOWER LIMB BEFORE OR DURING THE
MEASUREMENT PERIOD - Z89.411, Z89.412, Z89.419,
Z89.421, Z89.422, Z89.429, Z89.431, Z89.432, Z89.439,
Z89.441, Z89.442, Z89.449, Z89.511, Z89.512, Z89.519,
Z89.521, Z89.522, Z89.529, Z89.611, Z89.612, Z89.619,
Z89.621, Z89.622, Z89.629.

o All ABM Mandate encounters

Reporting Quarterly
Frequency
Unit Measure % foot examination for diabetic patients

International https://www.ncqa.org/hedis/measures/
comparison if https://www.ahrq.gov/
available https://www.qualityforum.org/QPS/QPSTool

Desired >76%
Direction
Data Source Centrally collected claim data (KEH)
Patient medical record

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 Primary Care (PC) Service JAWDA Performance Indicators

Type: chronic disease management Number: PC012

KPI
Description Percentage of Diabetics Receiving Annual Eye Exams
(title):
Domain Effectiveness
Indicator Type Process
Definition Percentage of patients ≥18 to ≤75 years of age with diabetes and an active
diagnosis of retinopathy in any part of the reporting quarter who had a
retinal or dilated eye exam by an eye care professional during the
reporting quarter OR diabetics with no diagnosis of retinopathy in any
part of the reporting quarter who had a retinal or dilated eye exam by an
eye care professional during the reporting quarter or in the 09 months
prior to the reporting quarter
Calculation Numerator
Patients with an eye screening for diabetic retinal disease. This includes
diabetics who had one of the following:

o Diabetic with a diagnosis of retinopathy during the reporting

quarter and a retinal image or dilated eye exam by an eye care
professional during the reporting quarter (Procedure codes with
ICD)
o Diabetic with no diagnosis of retinopathy in the reporting quarter
and a retinal image or dilated eye exam by an eye care professional
during the measurement quarter or within 09 months prior to the
reporting quarter (Procedure codes without ICD)

Retinal or Dilated Eye Exam Procedure Codes: 92134, 92275, 92132,

92133, 92136, 92242, 92265, 92270, 92275, 92283, 92284, 92285,
92225, 92226, 92230, 92235, 92260, 92499, 95060, 92240, 92250,
92260.

CPT: 92227, 92228, 92134

SERVICE CODE: 60

CPT Ophthalmological services: 92002, 92004, 92012, 92014, 92018,

92019

Numerator Guidance:
o The eye exam must be performed or reviewed by an ophthalmologist
or optometrist, or there must be evidence that fundus photography
results were read by a system that provides an artificial intelligence
(AI) interpretation.
o Eye exam can be performed in the same or different facility
o Timeframe: 12 months (prior to the end of reporting quarter)

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 Primary Care (PC) Service JAWDA Performance Indicators

= 3 months (quarter) + 09 months prior

Denominator
Total number of unique patients (≥18 to ≤75 years of age), with diabetes
related outpatient visit/s during the reporting quarter

AND

who had at least 2 diabetes related outpatient visits within 09 months, by

the same primary care unit/facility (prior to the reporting quarter)

Denominator Guidance
o Diabetes related outpatient visit is face-to-face visits with primary or
secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212,
99213, 99214, 99215, plus ICD 10 Codes: E10, E11, E13, O24 series
(See Appendix – B)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g.
ABM mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is
NOT considered a separate visit.

Denominator Exclusions:
o Patient with diagnosis of polycystic ovaries, gestational diabetes, or
steroid-induced diabetes (within the denominator time frame)
ICD 10 Codes: Gestational Diabetes: O24.410, O24.414,
O24.415, O24.419, O24.420, O24.424, O24.425, O24.429,
O24.430, O24.434, O24.435, O24.439.
Polycystic Ovaries: E28.2
STERIOD INDUCED DIABETES: E09.00, E09.01, E09.10, E09.11,
E09.21, E09.22, E09.29, E09.311, E09.319, E09.3211, E09.3212,
E09.3213, E09.3219, E09.3291, E09.3292, E09.3293, E09.3299,
E09.3311, E09.3312, E09.3313, E09.3319, E09.3391, E09.3392,
E09.3393, E09.3399, E09.3411, E09.3412, E09.3413, E09.3419,
E09.3491, E09.3492, E09.3493, E09.3499, E09.3511, E09.3512,
E09.3513, E09.3519, E09.3521, E09.3522, E09.3523, E09.3529,
E09.3531, E09.3532, E09.3533, E09.3539, E09.3541, E09.3542,
E09.3543, E09.3549, E09.3551, E09.3552, E09.3553, E09.3559,
E09.3591, E09.3592, E09.3593, E09.3599, E09.36, E09.37X1,
E09.37X2, E09.37X3, E09.37X9, E09.39, E09.40, E09.41, E09.42,
E09.43, E09.44, E09.49, E09.51, E09.52, E09.59, E09.610,
E09.618, E09.620, E09.621, E09.622, E09.628, E09.630,
E09.638, E09.641, E09.649, E09.65, E09.69, E09.8, E09.9.
o All ABM Mandate encounters
Reporting Quarterly
Frequency

Page | 16
 Primary Care (PC) Service JAWDA Performance Indicators

Unit Measure % annual retinal or dilated eye examination

Desired >52%
Direction
International Quality ID #117 (NQF 0055): Diabetes: Eye Exam (2022)
comparison if https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-
available Measures/2020_Measure_117_MIPSCQM.pdf
https://ecqi.healthit.gov/ecqm/ec/2021/cms131v9
Data Source • Centrally collected claim data (KEH)
• Patient clinical record

Type: Chronic disease management Number: PC013

KPI Description
(title): Percentage of Diabetics Receiving Annual Nephropathy Exams
Domain Effectiveness
Indicator Type Process
Definition Percentage of patients ≥18 to ≤75 years of age with diabetes who had a
nephropathy screening test or evidence of nephropathy during the
reporting quarter or in the 09 months prior to the reporting quarter
Calculation Numerator
Patients in the denominator population with a screening for nephropathy
or evidence of nephropathy can be performed in the same or different
facility within 12 months (prior to the end of reporting quarter)

Codes:
Any of the following conditions:
o Microalbuminuria/ Macroalbuminuria test: 82043.
o Estimated glomerular filtration rate (eGFR) and a urine
albumin-creatinine ratio (uACR): CPT:- 82570, 82042,
82044, 82565

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Denominator
Total number of unique patients (≥18 to ≤75 years of age), with diabetes
related outpatient visit/s during the reporting quarter

AND

Page | 17
 Primary Care (PC) Service JAWDA Performance Indicators

who had at least 2 diabetes related outpatient visits within 09 months, by

the same primary care unit/facility (prior to the reporting quarter)

Denominator Guidance
o Diabetes related outpatient visit is face-to-face visits with primary
or secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212,
99213, 99214, 99215, plus ICD 10 Codes: E10, E11, E13, O24 series
(See Appendix – B)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g.
ABM mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is
NOT considered a separate visit

Denominator Exclusions
o Patient with diagnosis of polycystic ovaries, gestational diabetes, or
steroid-induced diabetes (within the denominator time frame)
ICD 10 Codes: Gestational Diabetes: O24.410, O24.414, O24.415,
O24.419, O24.420, O24.424, O24.425, O24.429, O24.430,
O24.434, O24.435, O24.439.
Polycystic Ovaries: E28.2
STERIOD INDUCED DIABETES: E09.00, E09.01, E09.10, E09.11,
E09.21, E09.22, E09.29, E09.311, E09.319, E09.3211, E09.3212,
E09.3213, E09.3219, E09.3291, E09.3292, E09.3293, E09.3299,
E09.3311, E09.3312, E09.3313, E09.3319, E09.3391, E09.3392,
E09.3393, E09.3399, E09.3411, E09.3412, E09.3413, E09.3419,
E09.3491, E09.3492, E09.3493, E09.3499, E09.3511, E09.3512,
E09.3513, E09.3519, E09.3521, E09.3522, E09.3523, E09.3529,
E09.3531, E09.3532, E09.3533, E09.3539, E09.3541, E09.3542,
E09.3543, E09.3549, E09.3551, E09.3552, E09.3553, E09.3559,
E09.3591, E09.3592, E09.3593, E09.3599, E09.36, E09.37X1,
E09.37X2, E09.37X3, E09.37X9, E09.39, E09.40, E09.41, E09.42,
E09.43, E09.44, E09.49, E09.51, E09.52, E09.59, E09.610,
E09.618, E09.620, E09.621, E09.622, E09.628, E09.630,
E09.638, E09.641, E09.649, E09.65, E09.69, E09.8, E09.9.
DOCUMENTATION OF KIDNEY TRANSPLANT: ICD10: T86.10, T86.11,
T86.12, T86.13, T86.19, Z48.22, Z94.0.
o All ABM Mandate encounters
Reporting Quarterly
Frequency
Unit Measure % annual nephropathy screening test
Desired >92%
Direction

Page | 18
 Primary Care (PC) Service JAWDA Performance Indicators

International https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-
comparison if Measures/2020_Measure_119_MIPSCQM.pdf
available https://ecqi.healthit.gov/ecqm/ec/2022/cms134v10
https://mdinteractive.com/mips_quality_measure/2022-mips-quality-
measure-119
Data Source • Centrally collected claim data (KEH)
• Patient medical record

Type: Chronic disease management Number: PC014

KPI
Description Percentage of Patients with Controlled Hypertension (<130/80 mmHg)
(title):
Domain Effectiveness
Indicator Type Outcome
Definition Percentage of patients ≥18 to ≤85 years of age who had a diagnosis of
essential hypertension overlapping the measurement period and whose most
recent blood pressure was adequately controlled (< 130/80 mmHg) during
the reporting quarter
Calculation Numerator:
Patients whose most recent blood pressure is adequately controlled (systolic
blood pressure < 130 mmHg and diastolic blood pressure < 80 mmHg) during
the reporting quarter
Numerator Guidance:
o If no blood pressure is recorded during the measurement period, the
patient's blood pressure is assumed "not controlled."
o If there are multiple blood pressure readings on the same day, use the
reading with both the systolic and diastolic being in the normal range
(numerator values) as the most recent blood pressure reading.
o The most recent blood pressure reading during the reporting quarter
can be in the same primary care unit/facility.
Denominator:
Total number of unique patients ≥18 to ≤85 years of age, with hypertension
related outpatient visit/s during the reporting quarter

AND

Page | 19
 Primary Care (PC) Service JAWDA Performance Indicators

who had at least 2 hypertension related outpatient face-to-face visits

(primary or secondary diagnosis) within 09 months, by the same primary care
unit/facility (prior to the reporting quarter)

Denominator Guidance:
o Hypertension related outpatient visit is face-to-face visits with primary
or secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213,
99214, 99215, plus with the essential hypertension diagnoses (ICD-10
code: I10-I13)
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g. ABM
mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is NOT
considered a separate visit

Denominator Exclusions:
o Documentation of End stage renal disease (ESRD): ICD10: N18.6
(within the denominator time frame)
o Renal transplant (before or during the reporting quarter)
ICD codes: T86.10, T86.11, T86.12, T86.13, T86.19, Z48.22, Z94.0,
CPT codes: 90935- 90999 (Dialysis Services and Procedures CPT®
Code range) 90935, 90937, 90940, 90947, 90951, 90952, 90953,
90954, 90955, 90956, 90957, 90958, 90959, 90960, 90961,
90962, 90963, 90964, 90965, 90966, 90967, 90968, 90969,
90970, 90989, 90993, 90997, 90999.
o Pregnancy (during the reporting quarter) Appendix A (O00- O9A)
o All ABM Mandate encounters
Reporting Quarterly
Frequency
Unit Measure Percentage.
International https://mdinteractive.com/MIPS_Family_Practice
comparison if
available
Desired >64%
Direction
Data Source • Centrally collected claim data (KEH)
• Patient medical record

Page | 20
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Chronic disease management Number: PC016

KPI Description
(title): Percentage of Hypertensive Patients Receiving Annual Nephropathy
Exams
Domain Effectiveness
Indicator Type Process
Definition Percentage of patients ≥18 to ≤85 years of age with hypertension who
had a nephropathy screening test or evidence of nephropathy exam
during the reporting quarter or in the 09 months prior to the reporting
quarter
Calculation Numerator:
Patients in the denominator population with a screening for nephropathy
or evidence of nephropathy exam performed in the same or different
facility within 12 months (prior to the end of reporting quarter)

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Codes:
Any of the following conditions:
o Microalbuminuria/ Macroalbuminuria test: CPT: 82043.
o Estimated glomerular filtration rate (eGFR) and a urine albumin-
creatinine ratio (uACR): CPT: 82570, 82042, 82044, 82565

Denominator:
Total number of unique patients ≥18 to ≤85 years of age, with
hypertension related outpatient visit/s during the reporting quarter

AND

who had at least 2 hypertension related outpatient face-to-face visits

(primary or secondary diagnosis) within 09 months, by the same primary
care unit/facility (prior to the reporting quarter)

Denominator Guidance:
o Hypertension related outpatient visit is face-to-face visits with
primary or secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212,
99213, 99214, 99215, plus with the essential hypertension diagnoses
(ICD-10 code: I10-I13)

Page | 21
 Primary Care (PC) Service JAWDA Performance Indicators

o In case of multiple consultation visits within the reporting quarter,

please consider any visit after applying the exclusion criteria (e.g.
ABM mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is
NOT considered a separate visit

Denominator Exclusions:
o DOCUMENTATION OF KIDNEY TRANSPLANT: ICD10: T86.10,
T86.11, T86.12, T86.13, T86.19, Z48.22, Z94.0
(within the denominator time frame)
o Pregnancy (during the reporting quarter) Appendix B (O00- O9A)
o All ABM Mandate encounters
Reporting Quarterly
Frequency
Unit Measure % annual nephropathy screening test
International https://www.ncqa.org/hedis/measures/
comparison if https://www.ahrq.gov/
available https://www.qualityforum.org/QPS/QPSTool

Desired >90%
Direction
Data Source • Centrally collected claim data (KEH)
• Patient medical record

Page | 22
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Child health Number: PC021

KPI Description
(title): Autism Screening in children between 18 to 24 months
Domain Effectiveness
Indicator Type Process
Definition Percentage of children from (18 months to 24 months of age who
received at least 1 autism screening using an evidence-based tool.
Calculation Numerator:
Children from the denominator who had the screening for Autism using
evidence-based tool

ICD-10CM: Z13.4
CPT: 96110

Performance Met Criteria:

Up to 24 months age: at least 1

Denominator:
Total number of children (18 month to 24 months) who received well
child vaccination during the reporting quarter.

Denominator Guidance:
o The consultations should be by the same provider, however can be
by the same primary care unit/facility.
o In case of multiple consultation visits within the reporting quarter,
please consider any visit after applying the exclusion criteria (e.g.
ABM mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is
NOT considered a separate visit

ICD CODE: Z23

AND

CPT codes: Administration code: 90460, 90461, 90471, 90472,

90473, 90474.
Vaccine drug codes: 90296, 90696, 90697, 90698, 90700, 90702,
90714, 90715, 90723, 90389, 90713, 90707, 90710, 90644, 90647,
90648, 90748, 90396, 90716, 90670, 90632, 90633, 90634, 90636,
90680, 90681, 90630, 90653, 90654, 90655, 90656, 90657, 90658,
90660, 90661, 90662, 90664, 90666, 90667, 90668, 90672, 90673,
90674, 90682, 90685, 90686, 90687, 90688, 90756

Denominator Exclusions:

Page | 23
 Primary Care (PC) Service JAWDA Performance Indicators

o Current diagnosed conditions (ICD-10 CM: F84.0 - Autistic

disorder or other developmental disorders)
o All ABM Mandate encounters, except Well Child and
Immunization Mandate encounters.
o Self-pay encounters.
Reporting Quarterly
Frequency
Unit Measure Percentage
International DOH Standard Well Child visits (0-6 years)
comparison if https://www.cdc.gov/ncbddd/autism/hcp-screening.html
available https://www.doh.gov.ae/-
/media/256D066B50884B79ADF51238FABF2032.ashx

Desired Higher is better

Direction
Data Source • Centrally collected claim data (KEH)
• Patient medical record

Page | 24
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Chronic disease management Number: PC023

KPI
Description Percentage of Patients with Poorly Controlled Hypertension (>130
(title): mmHg or 80 mmHg)

Domain Effectiveness
Indicator Type Outcome
Definition Percentage of patients ≥18 to ≤85 years of age who had a diagnosis of
essential hypertension overlapping the measurement period and whose 2
abnormal readings in separate encounters in the last 3 months was (>130
mmHg or diastolic blood pressure >80 mmHg) during the reporting quarter.
Calculation Numerator:
Patients whose 2 abnormal readings in separate encounters in the last 3
months was (systolic blood pressure > 130 mmHg or diastolic blood pressure
> 80 mmHg) during the reporting quarter
Numerator Guidance:
o If no blood pressure is recorded during the measurement period, the
patient's blood pressure is assumed "not controlled."
o If there are multiple blood pressure readings on the same day, use the
reading with either the systolic or diastolic being in the abnormal range
(numerator values) as the most recent blood pressure readings.
o The most recent blood pressure reading during the reporting quarter
can be in the same primary care unit/facility.
Denominator:
Total number of unique patients ≥18 to ≤85 years of age, with hypertension
related outpatient visit/s during the reporting quarter

AND

who had at least 2 hypertension related outpatient face-to-face visits

(primary or secondary diagnosis) within 09 months, by the same primary care
unit/facility (prior to the reporting quarter)

Denominator Guidance:
o Hypertension related outpatient visit is face-to-face visits with primary
or secondary diagnosis
CPT Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213,
99214, 99215 plus with the essential hypertension diagnoses (ICD-10
code: I10-I13)

Page | 25
 Primary Care (PC) Service JAWDA Performance Indicators

o In case of multiple consultation visits within the reporting quarter,

please consider any visit after applying the exclusion criteria (e.g. ABM
mandate encounters excluded)
o As per DOH adjudication rule, 7-day follow-up from the last visit is NOT
considered a separate visit

Denominator Exclusions:
o Documentation of End stage renal disease (ESRD): ICD10: N18.6
(within the denominator time frame)
o Renal transplant (before or during the reporting quarter)
ICD codes: T86.10, T86.11, T86.12, T86.13, T86.19, Z48.22, Z94.0,
CPT codes: 90935- 90999 (Dialysis Services and Procedures CPT®
Code range) 90935, 90937, 90940, 90947, 90951, 90952, 90953,
90954, 90955, 90956, 90957, 90958, 90959, 90960, 90961,
90962, 90963, 90964, 90965, 90966, 90967, 90968, 90969,
90970, 90989, 90993, 90997, 90999.
o Pregnancy (during the reporting quarter) Appendix A (O00- O9A)
o All ABM Mandate encounters
Reporting Quarterly
Frequency
Unit Measure Percentage.
International https://mdinteractive.com/MIPS_Family_Practice
comparison if
available
Desired Lower is better
Direction
Data Source • Centrally collected claim data (KEH)
• Patient medical record

Page | 26
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Chronic disease management Number: PC024

KPI
Description Percentage of high-risk patients (18 years and above) who are screened
(title): for dyslipidemia
Domain Effectiveness
Indicator Type Process
Definition The percentage of high-risk patients ≥18 years who had a complete lipid profile
performed for screening of dyslipidemia within 1 year prior to the end of
reporting quarter. Dyslipidemia is diagnosed by measuring serum lipids.
Routine measurements (lipid profile) include total cholesterol (TC), TGs, HDL-
C, and LDL-C.
Calculation Numerator:
Number of patients (≥18 years of age) who had a complete lipid profile
performed for screening of dyslipidemia can be performed in the same or
different facility within 1 year prior to the end of reporting quarter.

Numerator Guidance:
Timeframe: 12 months (prior to the end of reporting quarter)
= 3 months (quarter) + 09 months prior

Denominator:
Number of high-risk patients ≥18 years of age, with at least one encounter to
within the same primary healthcare provider during the reporting quarter
AND
having at least one encounter within the 9 months prior to the start of the
reporting quarter

Denominator Guidance:
o High risk patients are:
Diabetes (Appendix B)
Hypertension (ICD-10 codes: I10-I13)
Cardiovascular Disease (ICD-10 codes: I20-I25)
Obesity with BMI >=30 (ICD-10 codes: E66)
o Face- to-face consultations should be included
o In case of multiple consultation visits within prior months, please
consider the latest one.
o As per DOH adjudication rule, 7-day follow-up from the last visit is NOT
considered a separate visit

Denominator Exclusions:
o Individuals with documented reason for not ordering dyslipidemia
screening (e.g.: refusal).
Patients with known diagnosis of dyslipidemia (ICD-10 codes: E78
series) prior to the first encounter in the same facility within the

Page | 27
 Primary Care (PC) Service JAWDA Performance Indicators

measurement time frame i.e. 12 months prior to the end of the

reporting quarter.
o Individuals who do not qualify for dyslipidemia screening insurance
benefits.
o Patient is in an urgent or emergent situation where time is of the
essence and to delay treatment would jeopardize the patient’s health
Status
o All ABM Mandate encounters.

Reporting Quarterly
Frequency
Unit Measure % Dyslipidemia Screening
International • https://www.cdc.gov/mmwr/preview/mmwrhtml/su6102a5.Htm
comparison if • DOH Standard for Obesity and Weight Diagnosis, Pharmacological and Surgical
Management Interventions
available
• DOH PROGRAM SERVICE REQUIREMENTS FOR THE PROVISION OF CARDIOVASCULAR
RISK FACTORS SCREENING AND FOLLOW-UP
• Standard for Diagnosis and Management of Diabetes Mellitus Type 1 and 2
• HAAD Guidelines for The Provision of Cardiovascular Disease Management Programs
Desired Higher is better
Direction
Data Source • Patient medical record

Page | 28
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Disease management Number: PC025

KPI
Description Percentage of adult patients (18 years and above) who are overweight
(title): or obese
Domain Effectiveness
Indicator Type Outcome
Definition This measure addresses the importance of both obesity and overweight.
Calculation Numerator:
Number of adult patients from the denominator with a documented BMI (BMI
range 25 and above) performed in the same facility.

Denominator:
Total number of adult patients who are 18 years age or older on the date of
the first encounter during the twelve months prior to the end of reporting
period within the same primary care facility

Denominator Guidance:
o Face-to-face consultations should be included

Denominator Exclusions:
o Patients who are not eligible for BMI Calculation or due to any of the
following:
• Patients receiving palliative care on the date of the current encounter
or any time prior to the current encounter.
• Patients who are pregnant on the date of the current encounter or
any time during the reporting period prior to the current encounter.
• Patients who refuse measurement of height and/or weight or refuse
follow-up on the date of the current encounter or any time during the
Reporting period prior to the current encounter.
• Patient is in an urgent or emergent medical situation where time is of
the essence, and to delay treatment would jeopardize the patient’s
health status.
Reporting Quarterly
Frequency
Unit Measure % obesity Screening
International https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-
comparison if Measures/2019_Measure_128_MIPSCQM.pdf
available
Desired Lower is better
Direction
Data Source • Patient medical record

Page | 29
 Primary Care (PC) Service JAWDA Performance Indicators

Type: Mental Health Number: PC026

KPI Description
(title): Primary Care Depression Treatment Success Rate
Domain Effectiveness
Indicator Type Outcome
Definition Percentage of patients treated for depression in primary care who show a
% reduction in depression scores (PHQ9) between 14 days to 180 days
Calculation Numerator: Total patients aged 18 years and older from the denominator
with 50% improvement of PHQ-9 scores between 14 days to 180 days
(follow-up) from initial PHQ-9 screening

Numerator guidance:
• At least one PHQ-9 score recorded between 14 days and 180 days
after baseline / index event.
• The best (i.e., lowest) PHQ-9 score observed between 14 days and
180 days after index event date to be considered as response.

Denominator: All adults aged 18 years and older patients who had a
positive PHQ-9 screening and were treated in the same primary care
center during the same period.

Denominator Exclusions:

o Patients having procedure code for a psychotherapy visit or a

depression psychotherapy code within the 180 days prior to the
denominator identification period.
o Patients who have ever been diagnosed with bipolar disorder
F31.10, F31.11, F31.12, F31.13, F31.2, F31.30, F31.31, F31.32,
F31.4, F31.5, F31.60, F31.61, F31.62, F31.63, F31.64, F31.70,
F31.71, F31.72, F31.73, F31.74, F31.75, F31.76, F31.77, F31.78,
F31.81, F31.89, F31.9
o All ABM Mandate encounters

Quarterly
Unit Measure % of depression patients with treatment success in primary care
International https://pmc.ncbi.nlm.nih.gov/articles/PMC5496323/pdf/13643_2017_Article_530.pdf
comparison if https://qpp.cms.gov/docs/QPP_quality_measure_specificatio
available ns/CQM-Measures/2019_Measure_411_MIPSCQM.pdf
https://psychiatryonline.org/doi/epdf/10.1176/appi.ps.201900295

Desire >50%
Direction
Data Source • Centrally collected claim data (KEH))
• Patient medical record

Page | 30
 Primary Care (PC) Service JAWDA Performance Indicators

APPENDIX – A ICD-10 CM CODES (O00- O9A)

O00.00 O00.01 O00.1 O00.201 O00.202 O00.209 O00.80 O00.81
O00.90 O00.91 O01.0 O01.1 O01.9
O02.0 O02.1 O02.81 O02.89 O02.9 O03.0 O03.1 O03.2
O03.30 O03.31 O03.32 O03.33 O03.34 O03.35 O03.36 O03.37
O03.38 O03.39 O03.4 O03.5 O03.6 O03.7 O03.80 O03.81
O03.82 O03.83 O03.84 O03.85 O03.86 O03.87 O03.88 O03.89
O03.9 O04.5 O04.6 O04.7 O04.80 O04.81 O04.82 O04.83
O04.84 O04.85 O04.86 O04.87 O04.88 O04.89 O07.0 O07.1
O07.2 O07.30 O07.31 O07.32 O07.33 O07.34 O07.35 O07.36
O07.37 O07.38 O07.39 O07.4 O08.0 O08.1 O08.2 O08.3
O08.4 O08.5 O08.6 O08.7 O08.81 O08.82 O08.83 O08.89
O08.9 O09.00 O09.01 O09.02 O09.03 O09.10 O09.11 O09.12
O09.13 O09.211 O09.212 O09.213 O09.219 O09.291 O09.292 O09.293
O09.299 O09.30 O09.31 O09.32 O09.33 O09.40 O09.41 O09.42
O09.43 O09.511 O09.512 O09.513 O09.519 O09.521 O09.522 O09.523
O09.529 O09.611 O09.612 O09.613 O09.619 O09.621 O09.622 O09.623
O09.629 O09.70 O09.71 O09.72 O09.73 O09.811 O09.812 O09.813
O09.819 O09.821 O09.822 O09.823 O09.829 O09.891 O09.892 O09.893
O09.899 O09.90 O09.91 O09.92 O09.93 O10.011 O10.012 O10.013
O10.019 O10.02 O10.03 O10.111 O10.112 O10.113 O10.119 O10.12
O10.13 O10.211 O10.212 O10.213 O10.219 O10.22 O10.23 O10.311
O10.312 O10.313 O10.319 O10.32 O10.33 O10.411 O10.412 O10.413
O10.419 O10.42 O10.43 O10.911 O10.912 O10.913 O10.919 O10.92
O10.93 O11.1 O11.2 O11.3 O11.9 O12.00 O12.01 O12.02
O12.03 O12.10 O12.11 O12.12 O12.13 O12.20 O12.21 O12.22
O12.23 O13.1 O13.2 O13.3 O13.9 O14.00 O14.02 O14.03
O14.10 O14.12 O14.13 O14.20 O14.22 O14.23 O14.90 O14.92
O14.93 O15.00 O15.02 O15.03 O15.1 O15.2 O15.9 O16.1
O16.2 O16.3 O16.9 O20.0 O20.8 O20.9 O21.0 O21.1
O21.2 O21.8 O21.9 O22.00 O22.01 O22.02 O22.03 O22.10
O22.11 O22.12 O22.13 O22.20 O22.21 O22.22 O22.23 O22.30
O22.31 O22.32 O22.33 O22.40 O22.41 O22.42 O22.43 O22.50
O22.51 O22.52 O22.53 O22.8X1 O22.8X2 O22.8X3 O22.8X9 O22.90
O22.91 O22.92 O22.93 O23.00 O23.01 O23.02 O23.03 O23.10
O23.11 O23.12 O23.13 O23.20 O23.21 O23.22 O23.23 O23.30
O23.31 O23.32 O23.33 O23.40 O23.41 O23.42 O23.43 O23.511
O23.512 O23.513 O23.519 O23.521 O23.522 O23.523 O23.529 O23.591
O23.592 O23.593 O23.599 O23.90 O23.91 O23.92 O23.93 O24.011
O24.012 O24.013 O24.019 O24.02 O24.03 O24.111 O24.112 O24.113
O24.119 O24.12 O24.13 O24.311 O24.312 O24.313 O24.319 O24.32
O24.33 O24.410 O24.414 O24.419 O24.420 O24.424 O24.429 O24.430
O24.434 O24.439 O24.811 O24.812 O24.813 O24.819 O24.82 O24.83
O24.911 O24.912 O24.913 O24.919 O24.92 O24.93 O25.10 O25.11
O25.12 O25.13 O25.2 O25.3 O26.00 O26.01 O26.02 O26.03

Page | 31
 Primary Care (PC) Service JAWDA Performance Indicators

O26.10 O26.11 O26.12 O26.13 O26.20 O26.21 O26.22 O26.23

O26.30 O26.31 O26.32 O26.33 O26.40 O26.41 O26.42 O26.43
O26.50 O26.51 O26.52 O26.53 O26.611 O26.612 O26.613 O26.619
O26.62 O26.63 O26.711 O26.712 O26.713 O26.719 O26.72 O26.73
O26.811 O26.812 O26.813 O26.819 O26.821 O26.822 O26.823 O26.829
O26.831 O26.832 O26.833 O26.839 O26.841 O26.842 O26.843 O26.849
O26.851 O26.852 O26.853 O26.859 O26.86 O26.872 O26.873 O26.879
O26.891 O26.892 O26.893 O26.899 O26.90 O26.91 O26.92 O26.93
O28.0 O28.1 O28.2 O28.3 O28.4 O28.5 O28.8 O28.9
O29.011 O29.012 O29.013 O29.019 O29.021 O29.022 O29.023 O29.029
O29.091 O29.092 O29.093 O29.099 O29.111 O29.112 O29.113 O29.119
O29.121 O29.122 O29.123 O29.129 O29.191 O29.192 O29.193 O29.199
O29.211 O29.212 O29.213 O29.219 O29.291 O29.292 O29.293 O29.299
O29.3X1 O29.3X2 O29.3X3 O29.3X9 O29.40 O29.41 O29.42 O29.43
O29.5X1 O29.5X2 O29.5X3 O29.5X9 O29.60 O29.61 O29.62 O29.63
O29.8X1 O29.8X2 O29.8X3 O29.8X9 O29.90 O29.91 O29.92 O29.93
O30.001 O30.002 O30.003 O30.009 O30.011 O30.012 O30.013 O30.019
O30.021 O30.022 O30.023 O30.029 O30.031 O30.032 O30.033 O30.039
O30.041 O30.042 O30.043 O30.049 O30.091 O30.092 O30.093 O30.099
O30.101 O30.102 O30.103 O30.109 O30.111 O30.112 O30.113 O30.119
O30.121 O30.122 O30.123 O30.129 O30.191 O30.192 O30.193 O30.199
O30.201 O30.202 O30.203 O30.209 O30.211 O30.212 O30.213 O30.219
O30.221 O30.222 O30.223 O30.229 O30.291 O30.292 O30.293 O30.299
O30.801 O30.802 O30.803 O30.809 O30.811 O30.812 O30.813 O30.819
O30.821 O30.822 O30.823 O30.829 O30.891 O30.892 O30.893 O30.899
O30.90 O30.91 O30.92 O30.93 O31.00X0 O31.00X1 O31.00X2 O31.00X3
O31.00X4 O31.00X5 O31.00X9 O31.01X0 O31.01X1 O31.01X2 O31.01X3 O31.01X4
O31.01X5 O31.01X9 O31.02X0 O31.02X1 O31.02X2 O31.02X3 O31.02X4 O31.02X5
O31.02X9 O31.03X0 O31.03X1 O31.03X2 O31.03X3 O31.03X4 O31.03X5 O31.03X9
O31.10X0 O31.10X1 O31.10X2 O31.10X3 O31.10X4 O31.10X5 O31.10X9 O31.11X0
O31.11X1 O31.11X2 O31.11X3 O31.11X4 O31.11X5 O31.11X9 O31.12X0 O31.12X1
O31.12X2 O31.12X3 O31.12X4 O31.12X5 O31.12X9 O31.13X0 O31.13X1 O31.13X2
O31.13X3 O31.13X4 O31.13X5 O31.13X9 O31.20X0 O31.20X1 O31.20X2 O31.20X3
O31.20X4 O31.20X5 O31.20X9 O31.21X0 O31.21X1 O31.21X2 O31.21X3 O31.21X4
O31.21X5 O31.21X9 O31.22X0 O31.22X1 O31.22X2 O31.22X3 O31.22X4 O31.22X5
O31.22X9 O31.23X0 O31.23X1 O31.23X2 O31.23X3 O31.23X4 O31.23X5 O31.23X9
O31.30X0 O31.30X1 O31.30X2 O31.30X3 O31.30X4 O31.30X5 O31.30X9 O31.31X0
O31.31X1 O31.31X2 O31.31X3 O31.31X4 O31.31X5 O31.31X9 O31.32X0 O31.32X1
O31.32X2 O31.32X3 O31.32X4 O31.32X5 O31.32X9 O31.33X0 O31.33X1 O31.33X2
O31.33X3 O31.33X4 O31.33X5 O31.33X9 O31.8X10 O31.8X11 O31.8X12 O31.8X13
O31.8X14 O31.8X15 O31.8X19 O31.8X20 O31.8X21 O31.8X22 O31.8X23 O31.8X24
O31.8X25 O31.8X29 O31.8X30 O31.8X31 O31.8X32 O31.8X33 O31.8X34 O31.8X35
O31.8X39 O31.8X90 O31.8X91 O31.8X92 O31.8X93 O31.8X94 O31.8X95 O31.8X99
O32.0XX0 O32.0XX1 O32.0XX2 O32.0XX3 O32.0XX4 O32.0XX5 O32.0XX9 O32.1XX0
O24.434 O24.439 O24.811 O24.812 O24.813 O24.819 O24.82 O24.83

Page | 32
 Primary Care (PC) Service JAWDA Performance Indicators

O24.911 O24.912 O24.913 O24.919 O24.92 O24.93 O25.10 O25.11

O25.12 O25.13 O25.2 O25.3 O26.00 O26.01 O26.02 O26.03
O26.10 O26.11 O26.12 O26.13 O26.20 O26.21 O26.22 O26.23
O26.30 O26.31 O26.32 O26.33 O26.40 O26.41 O26.42 O26.43
O26.50 O26.51 O26.52 O26.53 O26.611 O26.612 O26.613 O26.619
O26.62 O26.63 O26.711 O26.712 O26.713 O26.719 O26.72 O26.73
O26.811 O26.812 O26.813 O26.819 O26.821 O26.822 O26.823 O26.829
O26.831 O26.832 O26.833 O26.839 O26.841 O26.842 O26.843 O26.849
O26.851 O26.852 O26.853 O26.859 O26.86 O26.872 O26.873 O26.879
O26.891 O26.892 O26.893 O26.899 O26.90 O26.91 O26.92 O26.93
O28.0 O28.1 O28.2 O28.3 O28.4 O28.5 O28.8 O28.9
O29.011 O29.012 O29.013 O29.019 O29.021 O29.022 O29.023 O29.029
O29.091 O29.092 O29.093 O29.099 O29.111 O29.112 O29.113 O29.119
O29.121 O29.122 O29.123 O29.129 O29.191 O29.192 O29.193 O29.199
O29.211 O29.212 O29.213 O29.219 O29.291 O29.292 O29.293 O29.299
O29.3X1 O29.3X2 O29.3X3 O29.3X9 O29.40 O29.41 O29.42 O29.43
O29.5X1 O29.5X2 O29.5X3 O29.5X9 O29.60 O29.61 O29.62 O29.63
O29.8X1 O29.8X2 O29.8X3 O29.8X9 O29.90 O29.91 O29.92 O29.93
O30.001 O30.002 O30.003 O30.009 O30.011 O30.012 O30.013 O30.019
O30.021 O30.022 O30.023 O30.029 O30.031 O30.032 O30.033 O30.039
O30.041 O30.042 O30.043 O30.049 O30.091 O30.092 O30.093 O30.099
O30.101 O30.102 O30.103 O30.109 O30.111 O30.112 O30.113 O30.119
O30.121 O30.122 O30.123 O30.129 O30.191 O30.192 O30.193 O30.199
O30.201 O30.202 O30.203 O30.209 O30.211 O30.212 O30.213 O30.219
O30.221 O30.222 O30.223 O30.229 O30.291 O30.292 O30.293 O30.299
O30.801 O30.802 O30.803 O30.809 O30.811 O30.812 O30.813 O30.819
O30.821 O30.822 O30.823 O30.829 O30.891 O30.892 O30.893 O30.899
O30.90 O30.91 O30.92 O30.93 O31.00X0 O31.00X1 O31.00X2 O31.00X3
O31.00X4 O31.00X5 O31.00X9 O31.01X0 O31.01X1 O31.01X2 O31.01X3 O31.01X4
O31.01X5 O31.01X9 O31.02X0 O31.02X1 O31.02X2 O31.02X3 O31.02X4 O31.02X5
O31.02X9 O31.03X0 O31.03X1 O31.03X2 O31.03X3 O31.03X4 O31.03X5 O31.03X9
O31.10X0 O31.10X1 O31.10X2 O31.10X3 O31.10X4 O31.10X5 O31.10X9 O31.11X0
O31.11X1 O31.11X2 O31.11X3 O31.11X4 O31.11X5 O31.11X9 O31.12X0 O31.12X1
O31.12X2 O31.12X3 O31.12X4 O31.12X5 O31.12X9 O31.13X0 O31.13X1 O31.13X2
O31.13X3 O31.13X4 O31.13X5 O31.13X9 O31.20X0 O31.20X1 O31.20X2 O31.20X3
O31.20X4 O31.20X5 O31.20X9 O31.21X0 O31.21X1 O31.21X2 O31.21X3 O31.21X4
O31.21X5 O31.21X9 O31.22X0 O31.22X1 O31.22X2 O31.22X3 O31.22X4 O31.22X5
O31.22X9 O31.23X0 O31.23X1 O31.23X2 O31.23X3 O31.23X4 O31.23X5 O31.23X9
O31.30X0 O31.30X1 O31.30X2 O31.30X3 O31.30X4 O31.30X5 O31.30X9 O31.31X0
O31.31X1 O31.31X2 O31.31X3 O31.31X4 O31.31X5 O31.31X9 O31.32X0 O31.32X1
O31.32X2 O31.32X3 O31.32X4 O31.32X5 O31.32X9 O31.33X0 O31.33X1 O31.33X2
O31.33X3 O31.33X4 O31.33X5 O31.33X9 O31.8X10 O31.8X11 O31.8X12 O31.8X13
O31.8X14 O31.8X15 O31.8X19 O31.8X20 O31.8X21 O31.8X22 O31.8X23 O31.8X24
O31.8X25 O31.8X29 O31.8X30 O31.8X31 O31.8X32 O31.8X33 O31.8X34 O31.8X35
O31.8X39 O31.8X90 O31.8X91 O31.8X92 O31.8X93 O31.8X94 O31.8X95 O31.8X99

Page | 33
 Primary Care (PC) Service JAWDA Performance Indicators

O32.0XX0 O32.0XX1 O32.0XX2 O32.0XX3 O32.0XX4 O32.0XX5 O32.0XX9 O32.1XX0

O32.1XX1 O32.1XX2 O32.1XX3 O32.1XX4 O32.1XX5 O32.1XX9 O32.2XX0 O32.2XX1
O32.2XX2 O32.2XX3 O32.2XX4 O32.2XX5 O32.2XX9 O32.3XX0 O32.3XX1 O32.3XX2
O32.3XX3 O32.3XX4 O32.3XX5 O32.3XX9 O32.4XX0 O32.4XX1 O32.4XX2 O32.4XX3
O32.4XX4 O32.4XX5 O32.4XX9 O32.6XX0 O32.6XX1 O32.6XX2 O32.6XX3 O32.6XX4
O32.6XX5 O32.6XX9 O32.8XX0 O32.8XX1 O32.8XX2 O32.8XX3 O32.8XX4 O32.8XX5
O32.8XX9 O32.9XX0 O32.9XX1 O32.9XX2 O32.9XX3 O32.9XX4 O32.9XX5 O32.9XX9
O33.0 O33.1 O33.2 O33.3XX0 O33.3XX1 O33.3XX2 O33.3XX3 O33.3XX4
O33.3XX5 O33.3XX9 O33.4XX0 O33.4XX1 O33.4XX2 O33.4XX3 O33.4XX4 O33.4XX5
O33.4XX9 O33.5XX0 O33.5XX1 O33.5XX2 O33.5XX3 O33.5XX4 O33.5XX5 O33.5XX9
O33.6XX0 O33.6XX1 O33.6XX2 O33.6XX3 O33.6XX4 O33.6XX5 O33.6XX9 O33.7XX0
O33.7XX1 O33.7XX2 O33.7XX3 O33.7XX4 O33.7XX5 O33.7XX9 O33.8 O33.9
O34.00 O34.01 O34.02 O34.03 O34.10 O34.11 O34.12 O34.13
O34.211 O34.212 O34.219 O34.29 O34.30 O34.31 O34.32 O34.33
O34.40 O34.41 O34.42 O34.43 O34.511 O34.512 O34.513 O34.519
O34.521 O34.522 O34.523 O34.529 O34.531 O34.532 O34.533 O34.539
O34.591 O34.592 O34.593 O34.599 O34.60 O34.61 O34.62 O34.63
O34.70 O34.71 O34.72 O34.73 O34.80 O34.81 O34.82 O34.83
O34.90 O34.91 O34.92 O34.93 O35.0XX0 O35.0XX1 O35.0XX2 O35.0XX3
O35.0XX4 O35.0XX5 O35.0XX9 O35.1XX0 O35.1XX1 O35.1XX2 O35.1XX3 O35.1XX4
O35.1XX5 O35.1XX9 O35.2XX0 O35.2XX1 O35.2XX2 O35.2XX3 O35.2XX4 O35.2XX5
O35.2XX9 O35.3XX0 O35.3XX1 O35.3XX2 O35.3XX3 O35.3XX4 O35.3XX5 O35.3XX9
O35.4XX0 O35.4XX1 O35.4XX2 O35.4XX3 O35.4XX4 O35.4XX5 O35.4XX9 O35.5XX0
O35.5XX1 O35.5XX2 O35.5XX3 O35.5XX4 O35.5XX5 O35.5XX9 O35.6XX0 O35.6XX1
O35.6XX2 O35.6XX3 O35.6XX4 O35.6XX5 O35.6XX9 O35.7XX0 O35.7XX1 O35.7XX2
O35.7XX3 O35.7XX4 O35.7XX5 O35.7XX9 O35.8XX0 O35.8XX1 O35.8XX2 O35.8XX3
O35.8XX4 O35.8XX5 O35.8XX9 O35.9XX0 O35.9XX1 O35.9XX2 O35.9XX3 O35.9XX4
O35.9XX5 O35.9XX9 O36.0110 O36.0111 O36.0112 O36.0113 O36.0114 O36.0115
O36.0119 O36.0120 O36.0121 O36.0122 O36.0123 O36.0124 O36.0125 O36.0129
O36.0130 O36.0131 O36.0132 O36.0133 O36.0134 O36.0135 O36.0139 O36.0190
O36.0191 O36.0192 O36.0193 O36.0194 O36.0195 O36.0199 O36.0910 O36.0911
O36.0912 O36.0913 O36.0914 O36.0915 O36.0919 O36.0920 O36.0921 O36.0922
O36.0923 O36.0924 O36.0925 O36.0929 O36.0930 O36.0931 O36.0932 O36.0933
O36.0934 O36.0935 O36.0939 O36.0990 O36.0991 O36.0992 O36.0993 O36.0994
O36.0995 O36.0999 O36.1110 O36.1111 O36.1112 O36.1113 O36.1114 O36.1115
O36.1119 O36.1120 O36.1121 O36.1122 O36.1123 O36.1124 O36.1125 O36.1129
O36.1130 O36.1131 O36.1132 O36.1133 O36.1134 O36.1135 O36.1139 O36.1190
O36.1191 O36.1192 O36.1193 O36.1194 O36.1195 O36.1199 O36.1910 O36.1911
O36.1912 O36.1913 O36.1914 O36.1915 O36.1919 O36.1920 O36.1921 O36.1922
O36.1923 O36.1924 O36.1925 O36.1929 O36.1930 O36.1931 O36.1932 O36.1933
O36.1934 O36.1935 O36.1939 O36.1990 O36.1991 O36.1992 O36.1993 O36.1994
O36.1995 O36.1999 O36.20X0 O36.20X1 O36.20X2 O36.20X3 O36.20X4 O36.20X5
O36.20X9 O36.21X0 O36.21X1 O36.21X2 O36.21X3 O36.21X4 O36.21X5 O36.21X9
O36.22X0 O36.22X1 O36.22X2 O36.22X3 O36.22X4 O36.22X5 O36.22X9 O36.23X0
O36.23X1 O36.23X2 O36.23X3 O36.23X4 O36.23X5 O36.23X9 O36.4XX0 O36.4XX1
O36.4XX2 O36.4XX3 O36.4XX4 O36.4XX5 O36.4XX9 O36.5110 O36.5111 O36.5112

Page | 34
 Primary Care (PC) Service JAWDA Performance Indicators

O36.5113 O36.5114 O36.5115 O36.5119 O36.5120 O36.5121 O36.5122 O36.5123

O36.5124 O36.5125 O36.5129 O36.5130 O36.5131 O36.5132 O36.5133 O36.5134
O36.5135 O36.5139 O36.5190 O36.5191 O36.5192 O36.5193 O36.5194 O36.5195
O36.5199 O36.5910 O36.5911 O36.5912 O36.5913 O36.5914 O36.5915 O36.5919
O36.5920 O36.5921 O36.5922 O36.5923 O36.5924 O36.5925 O36.5929 O36.5930
O36.5931 O36.5932 O36.5933 O36.5934 O36.5935 O36.5939 O36.5990 O36.5991
O36.5992 O36.5993 O36.5994 O36.5995 O36.5999 O36.60X0 O36.60X1 O36.60X2
O36.60X3 O36.60X4 O36.60X5 O36.60X9 O36.61X0 O36.61X1 O36.61X2 O36.61X3
O36.61X4 O36.61X5 O36.61X9 O36.62X0 O36.62X1 O36.62X2 O36.62X3 O36.62X4
O36.62X5 O36.62X9 O36.63X0 O36.63X1 O36.63X2 O36.63X3 O36.63X4 O36.63X5
O36.63X9 O36.70X0 O36.70X1 O36.70X2 O36.70X3 O36.70X4 O36.70X5 O36.70X9
O36.71X0 O36.71X1 O36.71X2 O36.71X3 O36.71X4 O36.71X5 O36.71X9 O36.72X0
O36.72X1 O36.72X2 O36.72X3 O36.72X4 O36.72X5 O36.72X9 O36.73X0 O36.73X1
O36.73X2 O36.73X3 O36.73X4 O36.73X5 O36.73X9 O36.80X0 O36.80X1 O36.80X2
O36.80X3 O36.80X4 O36.80X5 O36.80X9 O36.8120 O36.8121 O36.8122 O36.8123
O36.8124 O36.8125 O36.8129 O36.8130 O36.8131 O36.8132 O36.8133 O36.8134
O36.8135 O36.8139 O36.8190 O36.8191 O36.8192 O36.8193 O36.8194 O36.8195
O36.8199 O36.8210 O36.8211 O36.8212 O36.8213 O36.8214 O36.8215 O36.8219
O36.8220 O36.8221 O36.8222 O36.8223 O36.8224 O36.8225 O36.8229 O36.8230
O36.8231 O36.8232 O36.8233 O36.8234 O36.8235 O36.8239 O36.8290 O36.8291
O36.8292 O36.8293 O36.8294 O36.8295 O36.8299 O36.8910 O36.8911 O36.8912
O36.8913 O36.8914 O36.8915 O36.8919 O36.8920 O36.8921 O36.8922 O36.8923
O36.8924 O36.8925 O36.8929 O36.8930 O36.8931 O36.8932 O36.8933 O36.8934
O36.8935 O36.8939 O36.8990 O36.8991 O36.8992 O36.8993 O36.8994 O36.8995
O36.8999 O36.90X0 O36.90X1 O36.90X2 O36.90X3 O36.90X4 O36.90X5 O36.90X9
O36.91X0 O36.91X1 O36.91X2 O36.91X3 O36.91X4 O36.91X5 O36.91X9 O36.92X0
O36.92X1 O36.92X2 O36.92X3 O36.92X4 O36.92X5 O36.92X9 O36.93X0 O36.93X1
O36.93X2 O36.93X3 O36.93X4 O36.93X5 O36.93X9 O40.1XX0 O40.1XX1 O40.1XX2
O40.1XX3 O40.1XX4 O40.1XX5 O40.1XX9 O40.2XX0 O40.2XX1 O40.2XX2 O40.2XX3
O40.2XX4 O40.2XX5 O40.2XX9 O40.3XX0 O40.3XX1 O40.3XX2 O40.3XX3 O40.3XX4
O40.3XX5 O40.3XX9 O40.9XX0 O40.9XX1 O40.9XX2 O40.9XX3 O40.9XX4 O40.9XX5
O40.9XX9 O41.00X0 O41.00X1 O41.00X2 O41.00X3 O41.00X4 O41.00X5 O41.00X9
O41.01X0 O41.01X1 O41.01X2 O41.01X3 O41.01X4 O41.01X5 O41.01X9 O41.02X0
O41.02X1 O41.02X2 O41.02X3 O41.02X4 O41.02X5 O41.02X9 O41.03X0 O41.03X1
O41.03X2 O41.03X3 O41.03X4 O41.03X5 O41.03X9 O41.1010 O41.1011 O41.1012
O41.1013 O41.1014 O41.1015 O41.1019 O41.1020 O41.1021 O41.1022 O41.1023
O41.1024 O41.1025 O41.1029 O41.1030 O41.1031 O41.1032 O41.1033 O41.1034
O41.1035 O41.1039 O41.1090 O41.1091 O41.1092 O41.1093 O41.1094 O41.1095
O41.1099 O41.1210 O41.1211 O41.1212 O41.1213 O41.1214 O41.1215 O41.1219
O41.1220 O41.1221 O41.1222 O41.1223 O41.1224 O41.1225 O41.1229 O41.1230
O41.1231 O41.1232 O41.1233 O41.1234 O41.1235 O41.1239 O41.1290 O41.1291
O41.1292 O41.1293 O41.1294 O41.1295 O41.1299 O41.1410 O41.1411 O41.1412
O41.1413 O41.1414 O41.1415 O41.1419 O41.1420 O41.1421 O41.1422 O41.1423
O41.1424 O41.1425 O41.1429 O41.1430 O41.1431 O41.1432 O41.1433 O41.1434
O41.1435 O41.1439 O41.1490 O41.1491 O41.1492 O41.1493 O41.1494 O41.1495

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 Primary Care (PC) Service JAWDA Performance Indicators

O41.1499 O41.8X10 O41.8X11 O41.8X12 O41.8X13 O41.8X14 O41.8X15 O41.8X19

O41.8X20 O41.8X21 O41.8X22 O41.8X23 O41.8X24 O41.8X25 O41.8X29 O41.8X30
O41.8X31 O41.8X32 O41.8X33 O41.8X34 O41.8X35 O41.8X39 O41.8X90 O41.8X91
O41.8X92 O41.8X93 O41.8X94 O41.8X95 O41.8X99 O41.90X0 O41.90X1 O41.90X2
O41.90X3 O41.90X4 O41.90X5 O41.90X9 O41.91X0 O41.91X1 O41.91X2 O41.91X3
O41.91X4 O41.91X5 O41.91X9 O41.92X0 O41.92X1 O41.92X2 O41.92X3 O41.92X4
O41.92X5 O41.92X9 O41.93X0 O41.93X1 O41.93X2 O41.93X3 O41.93X4 O41.93X5
O41.93X9 O42.00 O42.011 O42.012 O42.013 O42.019 O42.02 O42.10
O42.111 O42.112 O42.113 O42.119 O42.12 O42.90 O42.911 O42.912
O42.913 O42.919 O42.92 O43.011 O43.012 O43.013 O43.019 O43.021
O43.022 O43.023 O43.029 O43.101 O43.102 O43.103 O43.109 O43.111
O43.112 O43.113 O43.119 O43.121 O43.122 O43.123 O43.129 O43.191
O43.192 O43.193 O43.199 O43.211 O43.212 O43.213 O43.219 O43.221
O43.222 O43.223 O43.229 O43.231 O43.232 O43.233 O43.239 O43.811
O43.812 O43.813 O43.819 O43.891 O43.892 O43.893 O43.899 O43.90
O43.91 O43.92 O43.93 O44.00 O44.01 O44.02 O44.03 O44.10
O44.11 O44.12 O44.13 O45.001 O45.002 O45.003 O45.009 O45.011
O45.012 O45.013 O45.019 O45.021 O45.022 O45.023 O45.029 O45.091
O45.092 O45.093 O45.099 O45.8X1 O45.8X2 O45.8X3 O45.8X9 O45.90
O45.91 O45.92 O45.93 O46.001 O46.002 O46.003 O46.009 O46.011
O46.012 O46.013 O46.019 O46.021 O46.022 O46.023 O46.029 O46.091
O46.092 O46.093 O46.099 O46.8X1 O46.8X2 O46.8X3 O46.8X9 O46.90
O46.91 O46.92 O46.93 O47.00 O47.02 O47.03 O47.1 O47.9
O48.0 O48.1 O60.00 O60.02 O60.03 O60.10X0 O60.10X1 O60.10X2
O60.10X3 O60.10X4 O60.10X5 O60.10X9 O60.12X0 O60.12X1 O60.12X2 O60.12X3
O60.12X4 O60.12X5 O60.12X9 O60.13X0 O60.13X1 O60.13X2 O60.13X3 O60.13X4
O60.13X5 O60.13X9 O60.14X0 O60.14X1 O60.14X2 O60.14X3 O60.14X4 O60.14X5
O60.14X9 O60.20X0 O60.20X1 O60.20X2 O60.20X3 O60.20X4 O60.20X5 O60.20X9
O60.22X0 O60.22X1 O60.22X2 O60.22X3 O60.22X4 O60.22X5 O60.22X9 O60.23X0
O60.23X1 O60.23X2 O60.23X3 O60.23X4 O60.23X5 O60.23X9 O61.0 O61.1
O61.8 O61.9 O62.0 O62.1 O62.2 O62.3 O62.4 O62.8
O62.9 O63.0 O63.1 O63.2 O63.9 O64.0XX0 O64.0XX1 O64.0XX2
O64.0XX3 O64.0XX4 O64.0XX5 O64.0XX9 O64.1XX0 O64.1XX1 O64.1XX2 O64.1XX3
O64.1XX4 O64.1XX5 O64.1XX9 O64.2XX0 O64.2XX1 O64.2XX2 O64.2XX3 O64.2XX4
O64.2XX5 O64.2XX9 O64.3XX0 O64.3XX1 O64.3XX2 O64.3XX3 O64.3XX4 O64.3XX5
O64.3XX9 O64.4XX0 O64.4XX1 O64.4XX2 O64.4XX3 O64.4XX4 O64.4XX5 O64.4XX9
O64.5XX0 O64.5XX1 O64.5XX2 O64.5XX3 O64.5XX4 O64.5XX5 O64.5XX9 O64.8XX0
O64.8XX1 O64.8XX2 O64.8XX3 O64.8XX4 O64.8XX5 O64.8XX9 O64.9XX0 O64.9XX1
O64.9XX2 O64.9XX3 O64.9XX4 O64.9XX5 O64.9XX9 O65.0 O65.1 O65.2
O65.3 O65.4 O65.5 O65.8 O65.9 O66.0 O66.1 O66.2
O66.3 O66.40 O66.41 O66.5 O66.6 O66.8 O66.9 O67.0
O67.8 O67.9 O68 O69.0XX0 O69.0XX1 O69.0XX2 O69.0XX3 O69.0XX4
O69.0XX5 O69.0XX9 O69.1XX0 O69.1XX1 O69.1XX2 O69.1XX3 O69.1XX4 O69.1XX5
O69.1XX9 O69.2XX0 O69.2XX1 O69.2XX2 O69.2XX3 O69.2XX4 O69.2XX5 O69.2XX9
O69.3XX0 O69.3XX1 O69.3XX2 O69.3XX3 O69.3XX4 O69.3XX5 O69.3XX9 O69.4XX0

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 Primary Care (PC) Service JAWDA Performance Indicators

O69.4XX1 O69.4XX2 O69.4XX3 O69.4XX4 O69.4XX5 O69.4XX9 O69.5XX0 O69.5XX1

O69.5XX2 O69.5XX3 O69.5XX4 O69.5XX5 O69.5XX9 O69.81X0 O69.81X1 O69.81X2
O69.81X3 O69.81X4 O69.81X5 O69.81X9 O69.82X0 O69.82X1 O69.82X2 O69.82X3
O69.82X4 O69.82X5 O69.82X9 O69.89X0 O69.89X1 O69.89X2 O69.89X3 O69.89X4
O69.89X5 O69.89X9 O69.9XX0 O69.9XX1 O69.9XX2 O69.9XX3 O69.9XX4 O69.9XX5
O69.9XX9 O70.0 O70.1 O70.20 O70.21 O70.22 O70.23 O70.3
O71.02 O71.03 O71.1 O71.2 O71.3 O71.4 O71.5 O71.6
O71.7 O71.81 O71.82 O71.89 O71.9 O72.0 O72.1 O72.2
O72.3 O73.0 O73.1 O74.0 O74.1 O74.2 O74.3 O74.4
O74.5 O74.6 O74.7 O74.8 O74.9 O75.0 O75.1 O75.2
O75.3 O75.4 O75.5 O75.81 O75.82 O75.89 O75.9 O76
O77.0 O77.1 O77.8 O77.9 O80 O82 O85 O86.0
O86.11 O86.12 O86.13 O86.19 O86.20 O86.21 O86.22 O86.29
O86.4 O86.81 O86.89 O87.0 O87.1 O87.2 O87.3 O87.4
O87.8 O87.9 O88.011 O88.012 O88.013 O88.019 O88.02 O88.03
O88.111 O88.112 O88.113 O88.119 O88.12 O88.13 O88.211 O88.212
O88.213 O88.219 O88.22 O88.23 O88.311 O88.312 O88.313 O88.319
O88.32 O88.33 O88.811 O88.812 O88.813 O88.819 O88.82 O88.83
O89.01 O89.09 O89.1 O89.2 O89.3 O89.4 O89.5 O89.6
O89.8 O89.9 O90.0 O90.1 O90.2 O90.3 O90.4 O90.5
O90.6 O90.81 O90.89 O90.9 O91.011 O91.012 O91.013 O91.019
O91.02 O91.03 O91.111 O91.112 O91.113 O91.119 O91.12 O91.13
O91.211 O91.212 O91.213 O91.219 O91.22 O91.23 O92.011 O92.012
O92.013 O92.019 O92.02 O92.03 O92.111 O92.112 O92.113 O92.119
O92.12 O92.13 O92.20 O92.29 O92.3 O92.4 O92.5 O92.6
O92.70 O92.79 O94 O98.011 O98.012 O98.013 O98.019 O98.02
O98.03 O98.111 O98.112 O98.113 O98.119 O98.12 O98.13 O98.211
O98.212 O98.213 O98.219 O98.22 O98.23 O98.311 O98.312 O98.313
O98.319 O98.32 O98.33 O98.411 O98.412 O98.413 O98.419 O98.42
O98.43 O98.511 O98.512 O98.513 O98.519 O98.52 O98.53 O98.611
O98.612 O98.613 O98.619 O98.62 O98.63 O98.711 O98.712 O98.713
O98.719 O98.72 O98.73 O98.811 O98.812 O98.813 O98.819 O98.82
O98.83 O98.911 O98.912 O98.913 O98.919 O98.92 O98.93 O99.011
O99.012 O99.013 O99.019 O99.02 O99.03 O99.111 O99.112 O99.113
O99.119 O99.12 O99.13 O99.210 O99.211 O99.212 O99.213 O99.214
O99.215 O99.280 O99.281 O99.282 O99.283 O99.284 O99.285 O99.310
O99.311 O99.312 O99.313 O99.314 O99.315 O99.320 O99.321 O99.322
O99.323 O99.324 O99.325 O99.330 O99.331 O99.332 O99.333 O99.334
O99.335 O99.340 O99.341 O99.342 O99.343 O99.344 O99.345 O99.350
O99.351 O99.352 O99.353 O99.354 O99.355 O99.411 O99.412 O99.413
O99.419 O99.42 O99.43 O99.511 O99.512 O99.513 O99.519 O99.52
O99.53 O99.611 O99.612 O99.613 O99.619 O99.62 O99.63 O99.711
O99.712 O99.713 O99.719 O99.72 O99.73 O99.810 O99.814 O99.815
O99.820 O99.824 O99.825 O99.830 O99.834 O99.835 O99.840 O99.841
O99.842 O99.843 O99.844 O99.845 O99.89 O9A.111 O9A.112 O9A.113

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 Primary Care (PC) Service JAWDA Performance Indicators

O9A.119 O9A.12 O9A.13 O9A.211 O9A.212 O9A.213 O9A.219 O9A.22

O9A.23 O9A.311 O9A.312 O9A.313 O9A.319 O9A.32 O9A.33 O9A.411
O9A.412 O9A.413 O9A.419 O9A.42 O9A.43 O9A.511 O9A.512 O9A.513
O9A.519 O9A.52 O9A.53 O70.4 O70.9 O71.00

Appendix B – ICD-10 CM CODES (E10. E11, E13, O24 Series)

E10.10 E10.11 E10.21 E10.22 E10.29 E10.311 E10.319 E10.3211
E10.3212 E10.3213 E10.3219 E10.3291 E10.3292 E10.3293 E10.3299 E10.3311
E10.3312 E10.3313 E10.3319 E10.3391 E10.3392 E10.3393 E10.3399 E10.3411
E10.3412 E10.3413 E10.3419 E10.3491 E10.3492 E10.3493 E10.3499 E10.3511
E10.3512 E10.3513 E10.3519 E10.3521 E10.3522 E10.3523 E10.3529 E10.3531
E10.3532 E10.3533 E10.3539 E10.3541 E10.3542 E10.3543 E10.3549 E10.3551
E10.3552 E10.3553 E10.3559 E10.3591 E10.3592 E10.3593 E10.3599 E10.36
E10.37X1 E10.37X2 E10.37X3 E10.37X9 E10.39 E10.40 E10.41 E10.42
E10.43 E10.44 E10.49 E10.51 E10.52 E10.59 E10.610 E10.618
E10.620 E10.621 E10.622 E10.628 E10.630 E10.638 E10.641 E10.649
E10.65 E10.69 E10.8 E10.9 E11.00 E11.01 E11.21 E11.22
E11.29 E11.311 E11.319 E11.3211 E11.3212 E11.3213 E11.3219 E11.3291
E11.3292 E11.3293 E11.3299 E11.3311 E11.3312 E11.3313 E11.3319 E11.3391
E11.3392 E11.3393 E11.3399 E11.3411 E11.3412 E11.3413 E11.3419 E11.3491
E11.3492 E11.3493 E11.3499 E11.3511 E11.3512 E11.3513 E11.3519 E11.3521
E11.3522 E11.3523 E11.3529 E11.3531 E11.3532 E11.3533 E11.3539 E11.3541
E11.3542 E11.3543 E11.3549 E11.3551 E11.3552 E11.3553 E11.3559 E11.3591
E11.3592 E11.3593 E11.3599 E11.36 E11.37X1 E11.37X2 E11.37X3 E11.37X9
E11.39 E11.40 E11.41 E11.42 E11.43 E11.44 E11.49 E11.51
E11.52 E11.59 E11.610 E11.618 E11.620 E11.621 E11.622 E11.628
E11.630 E11.638 E11.641 E11.649 E11.65 E11.69 E11.8 E11.9
E13.00 E13.01 E13.10 E13.11 E13.21 E13.22 E13.29 E13.311
E13.319 E13.3211 E13.3212 E13.3213 E13.3219 E13.3291 E13.3292 E13.3293
E13.3299 E13.3311 E13.3312 E13.3313 E13.3319 E13.3391 E13.3392 E13.3393
E13.3399 E13.3411 E13.3412 E13.3413 E13.3419 E13.3491 E13.3492 E13.3493
E13.3499 E13.3511 E13.3512 E13.3513 E13.3519 E13.3521 E13.3522 E13.3523
E13.3529 E13.3531 E13.3532 E13.3533 E13.3539 E13.3541 E13.3542 E13.3543
E13.3549 E13.3551 E13.3552 E13.3553 E13.3559 E13.3591 E13.3592 E13.3593
E13.3599 E13.36 E13.37X1 E13.37X2 E13.37X3 E13.37X9 E13.39 E13.40
E13.41 E13.42 E13.43 E13.44 E13.49 E13.51 E13.52 E13.59
E13.610 E13.618 E13.620 E13.621 E13.622 E13.628 E13.630 E13.638
E13.641 E13.649 E13.65 E13.69 E13.8 E13.9 O24.011 O24.012
O24.013 O24.019 O24.02 O24.03 O24.111 O24.112 O24.113 O24.119
O24.12 O24.13 O24.311 O24.312 O24.313 O24.319 O24.32 O24.33
O24.811 O24.812 O24.813 O24.819 O24.82 O24.83

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 Primary Care (PC) Service JAWDA Performance Indicators

Summary of Changes 2025

KPI # Changes
PC001 – PC003, Retired the KPIs
PC006 - PC008, PC015
PC004 – PC005 Revised Title, definition, and KPI content (Numerator & Denominator)

PC009 - PC014, PC016 Revised Denominator & Denominator Guidance: Added “As per DOH
adjudication rule, 7-day follow-up from the last visit is NOT considered a
separate visit”
PC021 Revised Title, definition, and KPI content (Numerator & Denominator)
PC023 - PC026 Added new KPI

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