Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

Last updated: October 25, 2017

CMS Measure ID: CMS133v6
Version: 6
NQF Number: 0565
Measure Description:

Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following the cataract surgery

Initial Patient Population:

All patients aged 18 years and older who had cataract surgery and did not meet any exclusion criteria

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with significant ocular conditions impacting the visual outcome of surgery

Numerator Statement:

Patients who had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following cataract surgery

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Effective Clinical Care
Previous Version: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Improvement Notation:

Higher 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, including instances where more than one cataract procedure was performed during the measurement period. Every cataract surgery during the measurement period should be counted as a measurable denominator event for the measure calculation.

Only procedures performed during January 1 - September 30 of the reporting period will be considered for this measure, in order to determine if 20/40 or better visual acuity has been achieved within the 90 days following the cataract procedure. Cataract procedures performed during October 1 - December 31 are excluded from the initial population.

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 or eligible clinician 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.

Addendum Notes: Value Set content updated Sept 2017

Specifications

Release Notes

Header

  • ​Incremented eMeasure Version number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • ​Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • ​Updated Disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • ​​Updated Rationale.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Added 'and did not meet any exclusion criteria' to align Initial Population language across similar cataracts measures.

    Measure Section: Initial Population

    Source of Change: Expert Work Group Review

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 Amblyopia (2.16.840.1.113883.3.526.3.1448): Added 4 ICD10CM codes (H53.041, H53.042, H53.043, H53.049).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hereditary Corneal Dystrophies (2.16.840.1.113883.3.526.3.1424): Added 1 SNOMEDCT code (129623003).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Pathologic Myopia (2.16.840.1.113883.3.526.3.1432): Added 18 ICD10CM codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Degenerative Disorders of Globe (2.16.840.1.113883.3.526.3.1454): Added 18 ICD10CM codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Moderate or Severe Impairment, Better Eye, Profound Impairment Lesser Eye (2.16.840.1.113883.3.526.3.1464): Added 12 ICD10CM codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Profound Impairment, Both Eyes (2.16.840.1.113883.3.526.3.1476): Added 9 ICD10CM codes (H54.0X33, H54.0X34, H54.0X35, H54.0X43, H54.0X44, H54.0X45, H54.0X53, H54.0X54, H54.0X55).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

External Resources