Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Last updated: July 12, 2017

CMS Measure ID: CMS143v4
Version: 4
NQF Number: 0086
Measure Description:

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months

Initial Patient Population:

All patients aged 18 years and older with a diagnosis of primary open-angle glaucoma

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

None

Numerator Statement:

Patients who have an optic nerve head evaluation during one or more office visits within 12 months

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Documentation of medical reason(s) for not performing an optic nerve head evaluation

Measure Steward: American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Domain: Effective Clinical Care
Next Version: Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Previous Version: Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality

Guidance:

Optic nerve head evaluation includes examination of the cup to disc ratio and identification of optic disc or retinal nerve abnormalities. Both of these components of the optic nerve head evaluation are examined using ophthalmoscopy.

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.

Specifications

Release Notes

Header

  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Measure Developer updated.

Logic

  • Added temporal operator 'during' to describe the timing of the 'Diagnostic Study, Performed' in relation to the variable $EyeCareEncounters.
  • Changed data type of 'result' or 'finding' to 'performed'.
  • Introduced occurrencing on variables to enforce that the same instance of a clinical event is used throughout the measure when the logic within the variable does not limit the event to a single instance, e.g., FIRST or MOST RECENT.
  • 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.
  • Introduced variable $EyeCareEncounters to allow re-use of logical expressions and reduce redundancy/complexity.
  • Removed extraneous AND from Numerator and Denominator Exceptions.
  • 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

No changes

External Resources