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

Last updated: May 16, 2019

CMS Measure ID: CMS132v5
Version: 5
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 Populationinfo-icon

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: PCPI(R) Foundation (PCPI[R])
Domain: Patient Safety
Next Version:
Previous Version:
Measure Scoring: Proportion
Measure Type: Outcome
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 denominatorinfo-icon 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 specificityinfo-icon (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 professionalinfo-icon 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.

Notes: Value Set content updated
Quality ID: 192
High Priority Measure: Yes
Data Submission Method: EHR,Registry
Specialty Measure Set: Ophthalmology

Specifications

Release Notes

Header

  • ‚ÄčUpdated Copyright.

    Section: Copyright

    Source: Annual Update

  • Updated Disclaimer.

    Section: Disclaimer

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Updated Measure Developerinfo-icon.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Stewardinfo-icon.

    Section: Measure Steward

    Source: Measure Lead

  • 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: Denominator Exclusionsinfo-icon

    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 Setinfo-icon

  • Value set Retinal Repair Procedures (2.16.840.1.113883.3.526.3.1437): Deleted 1 CPT code (67112).

    Section: None

    Source: None

  • Value set Use of Systemic Sympathetic alpha-1a Antagonist Medication for Treatment of Prostatic Hypertrophy (2.16.840.1.113883.3.526.3.1442): Deleted 1 RXNORM code (1088455).

    Section: None

    Source: None

  • Value set Uveitis (2.16.840.1.113883.3.526.3.1444): Deleted 1 SNOMEDCT code (414602008).

    Section: None

    Source: None

  • Value set Glaucoma (2.16.840.1.113883.3.526.3.1423): Added 20 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

External Resources