DM Eye Exam

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
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      ​Thank you for your question regarding documentation required to meet the numerator criteria for CMS131v10.

      The numerator is looking for diabetic patients with an eye screening for diabetic retinal disease which can be achieved with either of the following scenarios:
      • a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period
      • no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period

      To meet the numerator criteria, you will need to map services to a code in the "Diabetic Retinopathy" value set and the "Retinal or Dilated Eye Exam" value set.

      You can map equivalent codes. Please keep the mapping information in case of an audit.
      Show
      ​Thank you for your question regarding documentation required to meet the numerator criteria for CMS131v10. The numerator is looking for diabetic patients with an eye screening for diabetic retinal disease which can be achieved with either of the following scenarios: • a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period • no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period To meet the numerator criteria, you will need to map services to a code in the "Diabetic Retinopathy" value set and the "Retinal or Dilated Eye Exam" value set. You can map equivalent codes. Please keep the mapping information in case of an audit.
    • we want to understand if this will support numerator performance. this will affect our overall performance score. thanks

      Will the following documentation support numerator performance ‘Met’ for the DM Eye Exam Quality Measure for 2022 reporting?

       

      Date 2.21.2022 Visit Note

      Diabetic Ocular Evaluation performed by eye care professional OD.  Complete visit note found in patient medical record.

      Patient declines dilated ophthalmoscopic exam

       

      Test

      Screening Retinal Photos

      Diagnostic Procedure: Retinal Photos – OU

      Device: Optimap

      Indication: Screening Testing

       

      Virtreous OD; Normal

      Optic Nerve OD; Normal

      Vessels OD; Normal

      Macula OD; Normal

      Periphery OD; Normal

       

      Virtreous OS; Normal

      Optic Nerve OS; Normal

      Vessels OS; Normal

      Macula OS; Normal

      Periphery OS; Normal

       

      Impression/Plan:

      Type II Diabetes without complications [E11.9]

       

      Thank you Stacey

       

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Stacey R Arens-Wilson (Inactive)
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