Last updated: July 12, 2017
| CMS Measure ID: | CMS131v5 |
|---|---|
| Version: | 5 |
| NQF Number: | 0055 |
| Measure Description: |
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period |
| Initial Patient Population: |
Patients 18-75 years of age with diabetes with a visit during the measurement period |
| Denominator Statement: |
Equals Initial Population |
| Denominator Exclusions: |
None |
| Numerator Statement: |
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: A retinal or dilated eye exam by an eye care professional in the measurement period or a negative retinal exam (no evidence of retinopathy) by an eye care professional in the year prior to the measurement period |
| Numerator Exclusions: |
Not Applicable |
| Denominator Exceptions: |
None |
| Measure Steward: | National Committee for Quality Assurance |
| Domain: | Effective Clinical Care |
| Next Version: | Diabetes: Eye Exam |
| Previous Version: | Diabetes: Eye Exam |
| Improvement Notation: |
Higher score indicates better quality |
| 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. |
| Addendum Notes: | ICD-10 Value Set addition |
| Quality ID: | 117 |
| High Priority Measure: | No |
| Data Submission Method: | Claims,CMS Web Interface,EHR,Registry |
| Specialty Measure Set: | Internal Medicine,Ophthalmology,General Practice/Family Medicine |
Specifications
CMS131v5_2.html
CMS131v5_2.xml- CMS131v5_SimpleXML_2.xml
EP_CMS131v5_NQF0055_Diab_Eye_2.zip
CMS131v5_TRN_04.01.16_0.xlsx
Release Notes
Header
Updated Clinical Recommendation Statement.
Section: Clinical Recommendation Statement
Source: Measure Lead
Updated Copyright.
Section: Copyright
Source: Annual Update
Incremented eMeasure Version number.
Section: eMeasure Version number
Source: Annual Update
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: Initial Population
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 Diabetes (2.16.840.1.113883.3.464.1003.103.12.1001): Added 11 ICD9CM codes (250.40, 357.2, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06, 362.07, 366.41, 648.00).
Section: None
Source: None
Value set Diabetes (2.16.840.1.113883.3.464.1003.103.12.1001): Added 156 ICD10CM codes.
Section: None
Source: ICD 10 Addendum