​​Thank you for your inquiry on CMS133v11: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery. Denominator exclusions should be removed from the measure population and denominator before determining if numerator criteria are met. Therefore, if a patient has significant ocular conditions that impact the visual outcome of the surgery, they should be categorized as option 1 regardless of if they also meet option 2 or 3.

For Quality ID #191 (QPP 191), we are running into a problem once we are imputing data for this measure. We have patients that are meeting more than one of the 3 options we can pick from. The options are: 1. pt has significant ocular condition impacting visual outcome of surgery 2. best corrected visual acuity of 20/40 or better achieved within the 90 days following cataract surgery 3. best corrected visual acuity of 20/40 or better not achieved within the 90 days following cataract surgery. We have patients that do have a diagnosis that qualifies as a significant ocular condition but they also meet either option 2 or 3 based on their visual acuity. Which one would be pick in these cases? If they have an ocular condition do we need to just pick option 1 or could we pick option 2 or 3 instead?