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  2. CQM-2276

EP_142v4 Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Done
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    • Guidance, Measure
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      ​Based on the measure logic, both of the scenarios identified in the inquiry would meet the numerator performance. Therefore, as long as the communication of the findings begins after the start of the eye care encounter, the numerator criteria would be met. However, it is likely that the level of severity of retinopathy and the absence or presence of macular edema would be assessed at the same encounter, so it would be likely that information would be available to be reported at the same time.

      It may be important to note that based on the implementation of this measure, the communication should occur as soon as possible after the exam is completed for all patients meeting the initial population/denominator criteria to ensure they are included in the reporting/measurement period.
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      ​Based on the measure logic, both of the scenarios identified in the inquiry would meet the numerator performance. Therefore, as long as the communication of the findings begins after the start of the eye care encounter, the numerator criteria would be met. However, it is likely that the level of severity of retinopathy and the absence or presence of macular edema would be assessed at the same encounter, so it would be likely that information would be available to be reported at the same time. It may be important to note that based on the implementation of this measure, the communication should occur as soon as possible after the exam is completed for all patients meeting the initial population/denominator criteria to ensure they are included in the reporting/measurement period.
    • CMS142v4/NQF0089

      As per CMS142v2 Numerator condition
      ◦AND: "Communication: From Provider to Provider: Level of Severity of Retinopathy Findings" starts after start of Occurrence A of $EyeCareEncounters
      ◦AND: Union of:
      "Communication: From Provider to Provider: Macular Edema Findings Present"
      "Communication: From Provider to Provider: Macular Edema Findings Absent"
      starts after start of Occurrence A of $EyeCareEncounters

      In above scenario, should Level of Severity of Retinopathy Findings AND Macular Edema Findings Present or Absent occur on same date or can have different start date but only criteria is after start of Occurrence A of $EyeCareEncounters?

      Scenario 1:

      EyeCare Encounter – startdate 1st Mar 2015
      Level of Severity of Retinopathy Findings – Startdate 2nd Mar 2015 5:45pm
      Macular Edema Findings Present or Absent – Startdate 15th Mar 2016 10:20am

      Scenario 2:

      EyeCare Encounter – startdate 1st Mar 2015
      Level of Severity of Retinopathy Findings – Startdate 2nd Mar 2015 5:45pm
      Macular Edema Findings Present or Absent – Startdate 2nd Mar 2015 5:45pm

      Which of the above scenario should qualify Numerator or both should meet performance?

            edave Mathematica EC eCQM Team
            pradnyag Pradnya Gokhale (Inactive)
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