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

Last updated: May 9, 2019

CMS Measure ID: CMS133v8
Version: 8
NQF Number: 565e
Measure Description:

Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract 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 in the operative eye within 90 days following the cataract surgery

Initial Population:

All cataract surgeries for patients aged 18 years and older who did not meet any exclusion criteria

Denominator Statement:

Equals Initial Populationinfo-icon

Denominator Exclusions:

Cataract surgeries in patients with significant ocular conditions impacting the visual outcome of surgery

Numerator Statement:

Cataract surgeries with best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye 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:
Measure Scoring: Proportion
Measure Type: Outcome
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 denominatorinfo-icon 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 populationinfo-icon.

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 or eligible clinicianinfo-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.

Quality ID: 191
Meaningful Measure: Management of Chronic Conditions

Specifications

Release Notes

Header

  • Updated eCQMinfo-icon version number.

    Measure Section: eCQM Version number

    Source of Change: Measure Lead

  • Added 'e' to NQFinfo-icon number.

    Measure Section: NQF Number

    Source of Change: Standards Update

  • Updated header statements to reflect the measure is episode-based, per cataract surgery, rather than patient-based.

    Measure Section: Description

    Source of Change: Expert Work Group Review

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated references to align with American Psychological Association (APA) style.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated header statements to reflect the measure is episode-based, per cataract surgery, rather than patient-based.

    Measure Section: Initial Populationinfo-icon

    Source of Change: Expert Work Group Review

  • Updated header statements to reflect the measure is episode-based, per cataract surgery, rather than patient-based.

    Measure Section: Denominator Exclusionsinfo-icon

    Source of Change: Expert Work Group Review

  • Updated header statements to reflect the measure is episode-based, per cataract surgery, rather than patient-based.

    Measure Section: Numeratorinfo-icon

    Source of Change: Expert Work Group Review

  • Updated parenthetical citations to align with American Psychological Association (APA) style.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Added data elements 'Cataract, Congenital,' 'Cataract, Mature or Hypermature,' 'Cataract, Posterior Polar,' 'Hypotony of Eye,' 'Macular Scar of Posterior Polar,' 'Morgagnian Cataract,' 'Posterior Lenticonus,' 'Retrolental Fibroplasias,' 'Traumatic Cataract,' and 'Vascular Disorders of Iris and Ciliary Body' to align with measure intent and clinical expert recommendation.

    Measure Section: Denominator Exclusions

    Source of Change: Expert Work Group Review

  • Removed data elements 'Chorioretinal Scars,' 'Moderate or Severe Impairment, Better Eye, Profound Impairment, Lesser Eye,' 'Other Corneal Deformities,' 'Other Disorders of Sclera,' 'Other Retinal Disorders,' and 'Profound Impairment, Both Eyes' to align with measure intent and clinical expert recommendation.

    Measure Section: Denominator Exclusions

    Source of Change: Expert Work Group Review

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

    Measure Section: Definitions and Functions

    Source of Change: Standards Update

  • Updated Clinical Quality Language (CQL) expression to conform with the HL7info-icon Standard: Clinical Quality Language Specificationinfo-icon, Release 1 STUinfo-icon 3 (CQL 1.3).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated definitions and functions in the Measure Authoring Tool (MATinfo-icon) Global Common Functions Library to align with standards changes, Clinical Quality Language (CQL) Style Guide, and to include two new functions related to calculating hospital stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-4.0.000).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

Value Setinfo-icon

The VSACinfo-icon is the source of truth for the value set content, please visit the VSAC for downloads of current value setsinfo-icon.

  • Direct reference code for Birth date (LOINC Code (21112-8)) now displayed in Human Readable.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Standardized purpose statement language in value sets across eCQMsinfo-icon. Value set purpose statements are visible in the Value Set Authority Center (VSAC) as well as the downloadable eCQM value set files.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • ​Removed code systeminfo-icon versions from direct reference codes. Please refer to Appendix A of the Electronic Clinical Quality Measureinfo-icon Logic and Implementation Guidance document for a list of code system versions used in the eCQM specificationsinfo-icon for 2020 reporting/performance.

    Measure Section: Terminology

    Source of Change: Standards Update

  • Value set Acute and Subacute Iridocyclitis (2.16.840.1.113883.3.526.3.1241): Added 35 SNOMED CT codes and deleted 5 SNOMED CT codes (11226001, 186266008, 193493000, 23798003, 416449002).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Cataract Secondary to Ocular Disorders (2.16.840.1.113883.3.526.3.1410): Added 1 SNOMED CT code (766837000) and deleted 1 SNOMED CT code (21818003).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Cloudy Cornea (2.16.840.1.113883.3.526.3.1417): Added 6 SNOMED CT codes (1099031000119105, 1099041000119101, 1099051000119104, 336501000119105, 342111000119101, 347271000119100).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Corneal Edema (2.16.840.1.113883.3.526.3.1418): Added 1 SNOMED CT code (373429003).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Corneal Opacity and Other Disorders of Cornea (2.16.840.1.113883.3.526.3.1419): Added 10 SNOMED CT codes (1099031000119105, 1099041000119101, 1099051000119104, 336501000119105, 342111000119101, 347271000119100, 193795008, 314005007, 422947009, 95726001).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Central Corneal Ulcer (2.16.840.1.113883.3.526.3.1428): Added 1 SNOMED CT code (7426009).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Open Wound of Eyeball (2.16.840.1.113883.3.526.3.1430): Deleted 2 ICD-10-CM codes (S05.91XA, S05.92XA).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Pathologic Myopia (2.16.840.1.113883.3.526.3.1432): Deleted 3 SNOMED CT codes (232133000, 232134006, 408757002).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Uveitis (2.16.840.1.113883.3.526.3.1444): Added 2 SNOMED CT codes (75315001, 75614007).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Visual Field Defects (2.16.840.1.113883.3.526.3.1446): Deleted 4 SNOMED CT codes (231780001, 296867007, 3499006, 48671003).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Amblyopia (2.16.840.1.113883.3.526.3.1448): Added 3 SNOMED CT codes (336451000119108, 342061000119102, 347241000119107).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Choroidal Hemorrhage and Rupture (2.16.840.1.113883.3.526.3.1452): Added 1 SNOMED CT code (2532009).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Disorders of Optic Chiasm (2.16.840.1.113883.3.526.3.1457): Deleted 1 SNOMED CT code (7869006).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Disorders of Visual Cortex (2.16.840.1.113883.3.526.3.1458): Added 3 SNOMED CT codes (342741000119103, 342751000119101, 732251003).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Hereditary Choroidal Dystrophies (2.16.840.1.113883.3.526.3.1462): Added 9 SNOMED CT codes (231996009, 231997000, 24950005, 41250005, 715417002, 715984007, 717761005, 720850008, 733110004).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Hereditary Retinal Dystrophies (2.16.840.1.113883.3.526.3.1463): Added 1 SNOMED CT code (764939004) and deleted 1 SNOMED CT code (68222009).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nystagmus and Other Irregular Eye Movements (2.16.840.1.113883.3.526.3.1465): Added 7 ICD-10-CM codes (H55.00, H55.02, H55.03, H55.04, H55.09, H55.81, H55.89). Added 9 ICD-9-CM codes (379.50, 379.52, 379.53, 379.54, 379.55, 379.56, 379.57, 379.58, 379.59). Added 57 SNOMED CT codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Other and Unspecified Forms of Chorioretinitis and Retinochoroiditis (2.16.840.1.113883.3.526.3.1468): Added 1 SNOMED CT code (314428001).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Other Disorders of Optic Nerve (2.16.840.1.113883.3.526.3.1471): Added 1 SNOMED CT code (733506009).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Prior Penetrating Keratoplasty (2.16.840.1.113883.3.526.3.1475): Added 1 SNOMED CT code (700281002).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Glaucoma (2.16.840.1.113883.3.526.3.1423): Added 3 SNOMED CT codes (15374009, 15996831000119101, 232083008).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Cataract, Congenital (2.16.840.1.113883.3.526.3.1412): Added Cataract, Congenital.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Cataract, Mature or Hypermature (2.16.840.1.113883.3.526.3.1413): Added Cataract, Mature or Hypermature.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Cataract, Posterior Polar (2.16.840.1.113883.3.526.3.1414): Added Cataract, Posterior Polar.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Hypotony of Eye (2.16.840.1.113883.3.526.3.1426): Added Hypotony of Eye.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Posterior Lenticonus (2.16.840.1.113883.3.526.3.1433): Added Posterior Lenticonus.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Retrolental Fibroplasias (2.16.840.1.113883.3.526.3.1438): Added Retrolental Fibroplasias.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Traumatic Cataract (2.16.840.1.113883.3.526.3.1443): Added Traumatic Cataract.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Vascular Disorders of Iris and Ciliary Body (2.16.840.1.113883.3.526.3.1445): Added Vascular Disorders of Iris and Ciliary Body.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Morgagnian Cataract (2.16.840.1.113883.3.526.3.1558): Added Morgagnian Cataract.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Macular Scar of Posterior Polar (2.16.840.1.113883.3.526.3.1559): Added Macular Scar of Posterior Polar.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Chorioretinal Scars (2.16.840.1.113883.3.526.3.1449): Removed Chorioretinal Scars.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Moderate or Severe Impairment, Better Eye, Profound Impairment Lesser Eye (2.16.840.1.113883.3.526.3.1464): Removed Moderate or Severe Impairment, Better Eye, Profound Impairment Lesser Eye.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Other Corneal Deformities (2.16.840.1.113883.3.526.3.1470): Removed Other Corneal Deformities.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Other Disorders of Sclera (2.16.840.1.113883.3.526.3.1472): Removed Other Disorders of Sclera.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Other Retinal Disorders (2.16.840.1.113883.3.526.3.1474): Removed Other Retinal Disorders.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

  • Value set Profound Impairment, Both Eyes (2.16.840.1.113883.3.526.3.1476): Removed Profound Impairment, Both Eyes.

    Measure Section: Terminology

    Source of Change: Expert Work Group Review

External Resources