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  2. CQM-7435

CMS131v12- QPP 117

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      Thank you for your inquiry regarding CMS131v13 (2025 Performance Period). According to the measure steward, the National Committee for Quality Assurance (NCQA), the patient in question should remain in the measure and would be considered noncompliant for the Eye Exam indicator. The prevalence of patients with prosthetic eyes is expected to be extremely low and unlikely to have significant impact on rates or comparability.
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      Thank you for your inquiry regarding CMS131v13 (2025 Performance Period). According to the measure steward, the National Committee for Quality Assurance (NCQA), the patient in question should remain in the measure and would be considered noncompliant for the Eye Exam indicator. The prevalence of patients with prosthetic eyes is expected to be extremely low and unlikely to have significant impact on rates or comparability.
    • CMS0131v13
    • CMS0131v12
    • Measure specification does not include a numerator or denominator exclusion for patient's with a prosthetic eye.

      This measure currently does not include any exclusion or exception for a patient with a prosthetic eye. In the rare case, which we have run into this year, the patient has an ocular prosthesis in both eyes and is counting against the numerator due to this not being part of the specifications. Can this please be considered in the future development/revision to this measure? 

            AIR EC eCQM Team AIR EC eCQM Team
            Torres Elisabeth
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