​Thank you for your inquiry specific to CMS142v11 (Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care).   Your inquiry indicates that you are utilizing the CMS value set for severity for retinopathy findings (value set “Level of Severity of Retinopathy Findings” (2.16.840.1.113883.3.526.3.1283)), however this value set is used for purposes of determining which denominator eligible patients meet the numerator criteria (i.e. patients with documentation, at least once within 12 months, of the findings of dilated macular or fundus exam via communication to the physician who manages the patient’s diabetic care), as well as denominator exceptions. Furthermore, this value set includes only 5 SNOMEDCT codes.   Specific to the denominator criteria, the denominator is equal to the initial population (all patients aged 18 years and older with a diagnosis of diabetic retinopathy), who had a dilated macular or fundus exam performed. The value set for “Diabetic Retinopathy” is OID 2.16.840.1.113883.3.526.3.327. When viewing the value set in the Value Set Authority Center ( https://vsac.nlm.nih.gov/), among other SNOMEDC and ICD10CM codes, we find the following two ICD10CM codes are included: - E11.3211- Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - E11.3212- Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye   E11.321 (Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema) is not included in the value set, because it does not provide the appropriate level of specificity. The ICD10 codes listed above include a higher level of specificity when coding for type 2 diabetes with mild nonproliferative diabetic retinopathy.   For purposes of reporting, we recommend you consult with your EMR vendor to ensure that you are mapping to the appropriate codes, as specified in the measure’s value sets.