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Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Compare Versions of: "Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Compare 2024 version to

Table Options
Measure Information 2024 Performance Period
Title Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
CMS eCQM ID CMS142v12
CBE ID* Not Applicable
MIPS Quality ID 019
Measure Steward American Academy of Ophthalmology
Description

Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the...

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Measure Scoring Proportion measure
Measure Type Process
Stratification

None

Risk Adjustment

None

Rationale

Diabetic retinopathy is a prevalent complication of diabetes, estimated to affect 28.5% of diabetic patients in the US (Zhang et al., 2010). Diabetic retinopathy is a key indicator of systemic complications of diabetes (Zhang et al., 2010). Coordination of care between the eye care...

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Clinical Recommendation Statement

The ophthalmologist should refer patients with diabetes to a primary care physician for appropriate management of their systemic condition and should communicate examination results to the physician managing the patient's ongoing diabetes care (III; Good Quality; Strong Recommendation)...

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Improvement Notation

Higher score indicates better quality

Definition

Communication - May include documentation in the medical record indicating that the findings of the dilated macular or fundus exam were communicated (e.g., verbally, by letter) with the clinician managing the patient's diabetic care OR a copy of a letter in the medical record to the...

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Guidance

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 SNOMED-CT does not uniformly include this distinction)....

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Initial Population

All patients aged 18 years and older with a diagnosis of diabetic retinopathy

Denominator

Equals Initial Population who had a dilated macular or fundus exam performed

Denominator Exclusions

None

Numerator

Patients with documentation, at least once within the measurement period, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient's diabetic care

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes.

Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus...

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Telehealth Eligible No
Next Version
Previous Version

Header

  • Revised language in description to align with measure logic by replacing 'within 12 months' with 'during the measurement period'.

    Measure Section: Description

    Source of Change: Measure Lead

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Annual Update

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section: Rationale

    Source of Change: Annual Update

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Revised guidance language to remove references to 'eligible professional' to align with CMS progrmamatic guidance.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Revised language in numerator to align with measure logic by replacing '12 months' with 'during the mesaurment period'.

    Measure Section: Numerator

    Source of Change: Measure Lead

Logic

  • Add 'day of Measurement Period' for harmonization with other measures.

    Measure Section: Definitions

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 3 SNOMED CT codes (183944003, 413310006, 413312003) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jun 03, 2024