DSE: Diabetes Screening for People With Schizophrenia or Bipolar Disorder Using Antipsychotic Medications
Percentage with at least one glucose or HbA1c during measurement year.
Measure description
Percentage with at least one glucose or HbA1c during measurement year.
Eligible population
Adults with schizophrenia/bipolar on antipsychotic
Performance drivers
Antipsychotic metabolic side effect monitoring.
Documentation & PA strategy
Annual fasting glucose or HbA1c required for SGA continuation in some plans.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure DSE measure?
Percentage with at least one glucose or HbA1c during measurement year.
What drives performance on this measure?
Antipsychotic metabolic side effect monitoring.
How should clinicians document for this measure?
Annual fasting glucose or HbA1c required for SGA continuation in some plans.
What is the eligible population?
Adults with schizophrenia/bipolar on antipsychotic
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