Skip to main content
Provider News Digest

Diabetic Kidney Testing Requirements for KED measure

HEDIS
Sep 30, 2026

Kidney health testing plays an important role in identifying and monitoring chronic kidney disease in patients with diabetes. For the Kidney Health Evaluation for Patients With Diabetes (KED) measure, both a blood test and a urine test are required.

Understanding which tests meet the measure criteria can help support accurate documentation and care gap closure. Below, you’ll find the applicable tests and CPT codes, including guidance on quantitative versus semi-quantitative urine albumin testing.

Tests included in the KED measure

Both of the following are needed to close a KED care gap:

  • Urine albumin-creatinine ratio (uACR): This may be completed using separate quantitative urine albumin and urine creatinine tests, provided the service dates are no more than four days apart. A semi-quantitative urine albumin does NOT meet measurement criteria.
  • Estimated glomerular filtration rate (eGFR): This blood test evaluates kidney function.

Why is quantitative testing required?

The National Committee for Quality Assurance (NCQA) specifies quantitative testing for this measure because quantitative results provide numeric values that may be used to evaluate and monitor kidney disease. Semi-quantitative results are reported in categories or ranges and may be useful for screening, but they do not satisfy the KED measure without a confirmatory quantitative test.

Providers may continue to order tests based on each patient’s clinical needs. When documenting services intended to close a KED care gap, the following CPT codes meet the measure criteria outlined for these tests:

TEST
CPT CODES
Urine albumin creatinine ratio lab test
N/A
No CPT code is available for the ratio. The individual urine tests must be billed separately.
Quantitative urine albumin lab test
82043
Urine creatinine lab test
82570
Estimated glomerular filtration rate lab test
80047, 80048, 80050, 80053, 80069, 82565

 

Coding reminder: CPT code 82043 represents the quantitative urine albumin test included in the KED measure. CPT code 82044, which represents a semi-quantitative urine albumin test, does NOT meet the measure criteria.

Additional Information

For additional information about the KED measure and conformant testing, visit NCQA’s KED measure resource. For questions, reach out to the Select Health Quality Improvement team via email.
Visit NCQA
qualityimprovement@selecthealth.org

REFERENCES

  1. National Committee for Quality Assurance. “Latest Update on NCQA Kidney Health Evaluation for the Patients With Diabetes (KED) Measure Specification: Conformant Tests.” NCQA, accessed September 10, 2026. https://www.ncqa.org/blog/latest-update-on-ncqa-kidney-health-evaluation-for-the-patients-with-diabetes-ked-measure-specification-conformant-tests/.
Other News
Closing Gaps for the AAP Measure
The HEDIS Adults' Access to Preventive/Ambulatory Health Services (AAP) measure evaluates whether adult patients age 20 and older have at least one qualifying ambulatory or preventive care visit. For Medicaid and Medicare patients, one qualifying visit during the measurement year closes the gap.
Read more
Screening for fall-risk patients
According to data from the Center for Disease Control (CDC), falls are the leading cause of injury-related deaths for adults ages 65 years and older. Falls are common, but preventable, when providers and patients have the right resources, screenings, and interventions in place.
Read more
HEDIS-recognized screenings detect colorectal cancer
Learn why Select Health encourages providers to continue using HEDIS-recognized screening methods for colorectal cancer instead of the SHIELD blood test.
Read more
Detect Diabetic Retinopathy Early with Regular Eye Exams
Regular retinal eye exams are one of the most effective ways to detect diabetic retinopathy early and help prevent vision loss.
Read more