Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

Last updated: May 5, 2017

CMS Measure ID: CMS133v5
Version: 5
NQF Number: 0565
Measure Description:

Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following the cataract surgery

Initial Patient Population:

All patients aged 18 years and older who had cataract surgery

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with significant ocular conditions impacting the visual outcome of surgery

Numerator Statement:

Patients who had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following cataract surgery

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Effective Clinical Care
Next Version: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Previous Version: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Improvement Notation:

Higher score indicates better quality

Guidance:

This is an episode-based measure, meaning there may be more than one reportable event for a given patient during the measurement period. The level of analysis for this measure is each cataract surgery during the measurement period, including instances where more than one cataract procedure was performed during the measurement period. Every cataract surgery during the measurement period should be counted as a measurable denominator event for the measure calculation.

Only procedures performed during January 1 - September 30 of the reporting period will be considered for this measure, in order to determine if 20/40 or better visual acuity has been achieved within the 90 days following the cataract procedure. Cataract procedures performed during October 1 - December 31 are excluded from the initial population.

The measure, as written, does not specifically require documentation of laterality. Coding limitations in particular clinical terminologies do not currently allow for that level of specificity (ICD-10-CM includes laterality, but ICD-9-CM and SNOMED-CT do not uniformly include this distinction). Therefore, at this time, it is not a requirement of this measure to indicate laterality of the diagnoses, findings or procedures. Available coding to capture the data elements specified in this measure has been provided. It is assumed that the eligible professional will record laterality in the patient medical record, as quality care and clinical documentation should include laterality.

This measure is to be reported by the clinician performing the cataract surgery procedure. Clinicians who provide only preoperative or postoperative management of cataract patients are not eligible for this measure.

Addendum Notes: ICD-10 Value Set addition

Specifications

Release Notes

Header

  • ​Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Updated Disclaimer.

    Section: Disclaimer

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Updated Measure Developer.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Steward.

    Section: Measure Steward

    Source: Measure Lead

  • Updated Rationale.

    Section: Rationale

    Source: Measure Lead

  • Updated References.

    Section: Reference

    Source: Measure Lead

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exclusions

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Amblyopia (2.16.840.1.113883.3.526.3.1448): Deleted 1 SNOMEDCT code (12541004).

    Section: None

    Source: None

  • Value set Uveitis (2.16.840.1.113883.3.526.3.1444): Deleted 1 SNOMEDCT code (414602008).

    Section: None

    Source: None

  • Value set Degeneration of Macula and Posterior Pole (2.16.840.1.113883.3.526.3.1453): Added 36 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

  • Value set Diabetic Macular Edema (2.16.840.1.113883.3.526.3.1455): Added 180 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

  • Value set Diabetic Retinopathy (2.16.840.1.113883.3.526.3.327): Added 240 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

  • Value set Glaucoma (2.16.840.1.113883.3.526.3.1423): Added 20 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

  • Value set Retinal Vascular Occlusion (2.16.840.1.113883.3.526.3.1479): Added 24 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

External Resources