​Thank you for your inquiry regarding CMS131v11, Diabetes: Eye Exam, for PY2023 ( https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS131v11.html ). The measure specifications are reviewed and updated on an annual basis. For the eCQM version, CPT 92229 will be considered for the next possible version of the measure, i.e., PY2025. The current eCQM value set "Retinal or Dilated Eye Exam" ( https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.115.12.1088/expansion/eCQM%20Update%202022-05-05 ) currently does not include CPT codes because the value set is mapped to QDM data type "Physical Exam" which does not include CPT as a recommended terminology ( https://mmshub.cms.gov/sites/default/files/Codes-Code-Systems-Value-Sets.pdf ). For eCQMs only, clinically equivalent services can be mapped to measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit.

We write to request that CPT 92229 be included in the eCQM and CQM for the diabetic eye exam quality measure to ensure consistency with MPFS CY22 and NCQA. The specifications for 2022 and 2023 state that AI is an allowable numerator action (see MPFS CY22). NCQA updated the value set in August 2022 (see MY2023 Vol 2 Value Set Director; Row 40018 for inclusion of CPT 92229). It appears that the CQM and eCQM have inadvertently not been updated to be consistent with MPFS CY22 and NCQA. Providers are reportedly required to make manual updates which could prevent access to this vision saving technology for people with diabetes. Thank you.