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

Last updated: May 17, 2016

CMS Measure ID: CMS133v4
Version: 4
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

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: American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Domain: Effective Clinical Care
Next Version: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Previous Version: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Measure Score: Proportion
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 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.

Specifications

Release Notes

Header

  • Added Item Count field. The Item Count identifies the unit of measure for the eCQM. For this episode-of-care measure, the unit of measure is each cataract surgery procedure.
  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Guidance updated.
  • Measure Developer updated.

Logic

  • Changed data type of 'result' or 'finding' to 'performed'.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • 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.
  • Replaced 'Measurement Start Date' and 'Measurement End Date' with 'Measurement Period' and as necessary, replaced existing timing operator (e.g., replacing 'starts before start of' with 'starts before end of').
  • 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

  • Value set Open Wound of Eyeball (OID 2.16.840.1.113883.3.526.3.1430): Deleted 1 SNOMED code (95762000).
  • Value set Visual Acuity 20/40 or Better (OID 2.16.840.1.113883.3.526.3.1483): Added 1 SNOMED code (423364005).
  • Value set Visual Field Defects (OID 2.16.840.1.113883.3.526.3.1446): Deleted 1 SNOMED code (193674006).

External Resources