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

Last updated: June 9, 2017

CMS Measure ID: CMS143v5
Version: 5
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: PCPI(R) Foundation (PCPI[R])
Domain: Effective Clinical Care
Next Version: Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Previous Version: Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
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.

Addendum Notes: ICD-10 Value Set addition
Quality ID: 12
High Priority Measure: No
Data Submission Method: Claims,EHR,Registry
Specialty Measure Set: Ophthalmology

Specifications

Release Notes

Header

  • ​Updated 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 Developer.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Steward.

    Section: Measure Steward

    Source: Measure Lead

  • Updated Rationale.

    Section: Rationale

    Source: Measure Lead

  • Updated Reference.

    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: Initial Population

    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 Set

  • Value set Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 1 SNOMEDCT code (161590003).

    Section: None

    Source: None

  • Value set Primary Open-Angle Glaucoma (2.16.840.1.113883.3.526.3.326): Added 20 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

External Resources