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  1. eCQM Issue Tracker
  2. CQM-4830

Add tractional retinal detachment as denominator exclusion

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Details

    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:
      ​CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

      Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract 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 in the operative eye within 90 days following the cataract surgery

      Description of Issue:
      ​​The expert work group evaluated the current denominator exclusions and found that the existing exclusion value set for 'Retinal Detachment with Retinal Defect' does not include concepts representing Tractional Retinal Detachment. This is a condition that would limit recovery of visual acuity after cataract surgery and should be included as an exclusion.

      Proposed Solution:
      ​Update the Value set for "Retinal Detachment with Retinal Defect: (2.16.840.1.113883.3.526.3.1478) to add:

      • 3 ICD-10-CM codes: H33.41, H33.42, H33.43

      Rationale for Change:
      ​Tractional Retinal Detachment is a condition that would limit recovery of visual acuity and should be considered a denominator exclusion for this measure.

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            khancock Mathematica EC eCQM Team
            khancock Mathematica EC eCQM Team
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            Dates

              Created:
              Updated: