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  2. CQM-7304

CMS 131: Diabetic Eye Exam

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      Thank you for your inquiry regarding CMS131v12 (2024 Performance Period). According to the measure steward, the National Committee for Quality Assurance (NCQA), to fulfill the criteria for this measure, ensure documentation aligns with the measure requirements and is recorded within the EHR. The measure looks for diabetic patients aged 18-75 who had an outpatient visit during the measurement period and received a retinal or dilated eye exam, based on whether they had retinopathy diagnosed during the period or within the previous year. Documentation should include exam details, date, results, and confirmation by an ophthalmologist or optometrist. Exams conducted externally must be recorded in the EHR using a SNOMEDCT code from the "Retinal or Dilated Eye Exam" value set. However, external results not documented in the EHR will not satisfy the measure criteria, regardless of where the exams were performed. For any further inquiries regarding MIPS eligibility, please submit your questions to the QPP helpdesk at QPP@cms.hhs.gov.
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      Thank you for your inquiry regarding CMS131v12 (2024 Performance Period). According to the measure steward, the National Committee for Quality Assurance (NCQA), to fulfill the criteria for this measure, ensure documentation aligns with the measure requirements and is recorded within the EHR. The measure looks for diabetic patients aged 18-75 who had an outpatient visit during the measurement period and received a retinal or dilated eye exam, based on whether they had retinopathy diagnosed during the period or within the previous year. Documentation should include exam details, date, results, and confirmation by an ophthalmologist or optometrist. Exams conducted externally must be recorded in the EHR using a SNOMEDCT code from the "Retinal or Dilated Eye Exam" value set. However, external results not documented in the EHR will not satisfy the measure criteria, regardless of where the exams were performed. For any further inquiries regarding MIPS eligibility, please submit your questions to the QPP helpdesk at QPP@cms.hhs.gov .
    • CMS0131v12

      When patients have undergone an external eye exam outside of UM prior to their office visit, does the measure require them to provide documentation? Additionally, does the measure require that the exam results be recorded in the EHR?

            AIR EC eCQM Team AIR EC eCQM Team
            Jvela001 Jesus L Velasquez
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