Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures

Last updated: July 12, 2017

CMS Measure ID: CMS132v4
Version: 4
NQF Number: 0564
Measure Description:

Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and had any of a specified list of surgical procedures in the 30 days following cataract surgery which would indicate the occurrence of any of the following major complications: retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence

Initial Patient Population:

All patients aged 18 years and older who had cataract surgery and no significant ocular conditions impacting the surgical complication rate

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with any one of a specified list of significant ocular conditions that impact the surgical complication rate

Numerator Statement:

Patients who had one or more specified operative procedures for any of the following major complications within 30 days following cataract surgery: retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Domain: Patient Safety
Next Version: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures
Previous Version: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures
Measure Score: Proportion
Improvement Notation:

Lower 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. Every cataract surgery during the measurement period should be counted as a measurable denominator event for the measure calculation.

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.

Specifications

Release Notes

Header

  • Added Item Count field. The Item Count identifies the unit of measure for the eCQM. For this episode-of-care measure, the unit of measure is each cataract surgery procedure.
  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Guidance updated.
  • Measure Developer updated.

Logic

  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced the new timing operator 'overlaps' to replace two lines of logic (AND/AND NOT) or to enforce when an event or set of events occur to meet the measure intent.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.

Value Sets

  • Value set Anomalies of Pupillary Function (OID 2.16.840.1.113883.3.526.3.1406): Updated value set name from Anomalies of Pupillary Function to Anomalies of Pupillary Function.
  • Value set Open Wound of Eyeball (OID 2.16.840.1.113883.3.526.3.1430): Deleted 1 SNOMED code (95762000).
  • Value set Posterior Lenticonus (OID 2.16.840.1.113883.3.526.3.1433): Added 1 SNOMED code (33521009) and deleted 1 SNOMED code (204132007).
  • Value set Vitreous Procedures (OID 2.16.840.1.113883.3.526.3.1447): Deleted 1 CPT Code (67028).

External Resources