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CMS 143 Numerator Question

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      Thank you for your inquiry regarding the CMS143v12 Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation measure. The initial population includes patients with a diagnosis of primary open-angle glaucoma, and in the specification the Rationale explains that patients with glaucoma have optic nerve head or retinal nerve abnormalities. The optic disc exam for these patients will therefore never show normal results. This also explains why the result value set Optic Disc Exam for Structural Abnormalities (2.16.840.1.113883.3.526.3.1334) contains codes that indicate only abnormal findings (71486-5: Left eye Optic disc or retinal nerve fiber layer structural abnormalities by Ophthalmoscopy; 71487-3: Right eye Optic disc or retinal nerve fiber layer structural abnormalities by Ophthalmoscopy). Since patients with glaucoma will have these one of these abnormalities on exam, a normal result is not possible and therefore will not meet numerator criteria.
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      Thank you for your inquiry regarding the CMS143v12 Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation measure. The initial population includes patients with a diagnosis of primary open-angle glaucoma, and in the specification the Rationale explains that patients with glaucoma have optic nerve head or retinal nerve abnormalities. The optic disc exam for these patients will therefore never show normal results. This also explains why the result value set Optic Disc Exam for Structural Abnormalities (2.16.840.1.113883.3.526.3.1334) contains codes that indicate only abnormal findings (71486-5: Left eye Optic disc or retinal nerve fiber layer structural abnormalities by Ophthalmoscopy; 71487-3: Right eye Optic disc or retinal nerve fiber layer structural abnormalities by Ophthalmoscopy). Since patients with glaucoma will have these one of these abnormalities on exam, a normal result is not possible and therefore will not meet numerator criteria.
    • CMS0143v12

       I need clarification on eCQM 143 Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation for the PY 2024. The specifications state the patient needs to have an optic nerve head evaluation during one or more visits within 12 months. The Optic Disc Exam for Structural Abnormalities (2.16.840.1.113883.3.526.3.1334) value sets contains a LOINC code for a result, but it does not provide specifics on the result being normal vs. abnormal.

      The question we have is this - does the documentation of a normal result from the optic disc exam documentation meet the numerator critieria for the "Optin Disc Exam Performed with Result"?

            AIR EC eCQM Team AIR EC eCQM Team
            k.rouantree@nextech.com Kaitlin Rouantree
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