Diabetes: Eye Exam

Last updated: May 18, 2016

CMS Measure ID: CMS131v3
Version: 3
NQF Number: 0055
Measure Description:

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

Initial Patient Population:

Patients 18-75 years of age with diabetes with a visit during the measurement period

Denominator Statement:

Equals Initial Patient Population

Denominator Exclusions:

None

Numerator Statement:

Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:

  • A retinal or dilated eye exam by an eye care professional in the measurement period
  • A negative retinal exam (no evidence of retinopathy) by an eye care professional in the year prior to the measurement period
Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
National Quality Strategy Domain: Effective Clinical Care
Next Version: Diabetes: Eye Exam
Measure Score: Proportion
Score Type: Process
Improvement Notation:

Higher score indicates better quality

Guidance:

Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included.

The eye exam must be performed by an ophthalmologist or optometrist.

Specifications

External Resources