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Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

General eCQM Information

CMS Measure ID CMS143v9
NQF Number 0086e
Measure Description

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months

Initial Population All patients aged 18 years and older with a diagnosis of primary open-angle glaucoma
Denominator Statement

Equals Initial Population

Denominator Exclusions

None

Numerator Statement

Patients who have an optic nerve head evaluation during one or more office visits within 12 months

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not performing an optic nerve head evaluation

Measure Steward PCPI(R) Foundation (PCPI[R])
Domain Effective Clinical Care
Measure Scoring Proportion measure
Measure Type Process measure
Improvement Notation

Higher score indicates better quality

Guidance

Optic nerve head evaluation includes examination of the cup to disc ratio and identification of optic disc or retinal nerve abnormalities. Both of these components of the optic nerve head evaluation are examined using ophthalmoscopy.

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). 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 or eligible clinician will record laterality in the patient medical record, as quality care and clinical documentation should include laterality.

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.

Quality ID 12
Meaningful Measure Management of Chronic Conditions
Telehealth Eligible No
Next Version
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Release Notes

Header

  • Updated eCQM Version Number.

    Measure Section: eCQM Version Number

    Source of Change: Standards Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Standards Update

  • Revised rationale based upon most recent National Quality Forum (NQF) maintenance submission.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated in-text citations to align with American Psychological Association (APA) formatting.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references to align with most recent NQF maintenance submission and APA formatting.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Added text to identify the Quality Data Model (QDM) version used in the measure specification.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Added text to indicate whether the measure is patient-based or episode-based.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Revised guidance to remove reference to ICD-9-CM as this terminology is no longer included in the technical specifications.

    Measure Section: Guidance

    Source of Change: Measure Lead

Logic

  • Updated the names of Clinical Quality Language (CQL) definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Definitions

    Source of Change: Standards Update

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Functions

    Source of Change: Standards Update

  • QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

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 Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 5 SNOMED CT codes 216952002, 274512008, 371133007, 416406003, 445528004 based on expert review and/or public feedback. Removed codes due to intent of concepts which do not indicate a medical contraindication, but rather a provider decision to discontinue something or change a course of treatment.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 SNOMED CT code (17436001) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Added 3 CPT codes 99315, 99316, 99318) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations, to capture additional nursing facility visit encounter types.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Primary Open-Angle Glaucoma (2.16.840.1.113883.3.526.3.326): Deleted 4 ICD-9-CM codes 365.10, 365.11, 365.12, 365.15). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed ICD-9-CM extensional value sets from applicable Groupings due to ICD-9-CM no longer being maintained and the measure not requiring historical lookback period.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: May 05, 2021