With regards to the "Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care" clinical quality measure, eMeasure 142/NQF 0089, the "Level of Severity of Retinopathy Findings" value set, oid 2.16.840.1.113883.3.526.3.1324, appears to be incomplete. It includes values for preproliferative, mild, moderate, and severe nonproliferative diabetic retinopathy. However, in contains no entries for proliferative or background diabetic retinopathy. I especially believe that these values belong in that value set since patients with this level of retinopathy do fall into the IPP and Denominator.

As the CQM stands, patients with proliferative diabetic retinopathy (ICD-9 code 362.02) fall into the denominator per the "Diabetic Retinopathy" value set with oid 2.16.840.1.113883.3.526.3.327, but the provider can never achieve the numerator for those patients, since communicating their levels of retinopathy does not qualify them for the numerator. The same is true for background diabetic retinopathy (ICD-9 code 362.01).

I have verified the value set from several sources, and all appear to corroborate that discrepancy.