| CMS Measure ID |
CMS131v9
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CMS131v10
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CMS131v11
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| NQF Number |
Not Applicable
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Not Applicable
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Not Applicable
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| Measure Description |
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
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Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
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Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period
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| Initial Population |
Patients 18-75 years of age with diabetes with a visit during the measurement period
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Patients 18-75 years of age with diabetes with a visit during the measurement period
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Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period
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| Denominator Statement |
Equals Initial Population
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Equals Initial Population
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Equals Initial Population
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| Denominator Exclusions |
Exclude patients whose hospice care overlaps the measurement period.
Exclude patients 66 and older who are living long term in an institution for more than 90 consecutive days during the measurement period.
Exclude patients 66 and older with advanced illness and frailty because it is unlikely that patients will benefit from the services being measured.
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Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients 66 and older who are living long term in an institution for more than 90 consecutive days during the measurement period.
Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following criteria:
- Advanced illness with two outpatient encounters during the measurement period or the year prior
- OR advanced illness with one inpatient encounter during the measurement period or the year prior
- OR taking dementia medications during the measurement period or the year prior
Exclude patients receiving palliative care during the measurement period.
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Exclude patients who are in hospice care for any part of the measurement period.Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness with two outpatient encounters during the measurement period or the year prior- OR advanced illness with one inpatient encounter during the measurement period or the year prior- OR taking dementia medications during the measurement period or the year priorExclude patients receiving palliative care for any part of the measurement period.
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| Numerator Statement |
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
•Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
•Diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
|
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
•Diabetic with a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
•Diabetic with no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
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Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: •Diabetic with a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period •Diabetic with no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period
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| Numerator Exclusions |
Not Applicable
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Not Applicable
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Not Applicable
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| Denominator Exceptions |
None
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None
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None
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| Measure Steward |
National Committee for Quality Assurance
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National Committee for Quality Assurance
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National Committee for Quality Assurance
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| Quality Domain |
Effective Clinical Care
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Effective Clinical Care
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Effective Clinical Care
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| Measure Scoring |
Proportion measure
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Proportion measure
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Proportion measure
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| Measure Type |
Process measure
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Process measure
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Process measure
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| Improvement Notation |
Higher score indicates better quality
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Higher score indicates better quality
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Higher score indicates better quality
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| Guidance |
Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.
The eye exam must be performed by an ophthalmologist or optometrist.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
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Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.
The eye exam must be performed 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.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
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The eye exam must be performed 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. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
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| MIPS Quality ID |
117
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117
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117
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| Meaningful Measure |
Management of Chronic Conditions
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Management of Chronic Conditions
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Management of Chronic Conditions
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| Telehealth Eligible |
Yes
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Yes
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Yes
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| Next Version |
CMS131v10
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CMS131v11
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No Version Available
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| Previous Version |
No Version Available
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