| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, EHR, Registry | Process | No | Effective Clinical Care | Ophthalmology |
Measure Description
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
Instruction
This measure is to be reported a minimum of once per performance period for patients seen during the performance period. It is anticipated that eligible clinicians who provide the primary management of patients with primary open-angle glaucoma (in either one or both eyes) will submit this measure.
Denominator
All patients aged 18 years and older with a diagnosis of primary open-angle glaucoma
DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for registry-based measures.
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for primary open-angle glaucoma (ICD-10-CM): H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.1110, H40.1111, H40.1112, H40.1113, H40.1114, H40.1120, H40.1121, H40.1122, H40.1123, H40.1124, H40.1130, H40.1131, H40.1132, H40.1133, H40.1134, H40.1190, H40.1191, H40.1192, H40.1193, H40.1194, H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224, H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.1290, H40.1291, H40.1292, H40.1293, H40.1294, H40.151, H40.152, H40.153, H40.159
AND
Patient encounter during the performance period (CPT): 92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
WITHOUT
Telehealth Modifier: GQ, GT
Numerator
Patients who have an optic nerve head evaluation during one or more office visits within 12 months
Numerator Options:
Performance Met: Optic nerve head evaluation
performed (2027F)
OR
Denominator Exception: Documentation of medical reason(s) for
not performing an optic nerve head evaluation (2027F with 1P)
OR
Performance Not Met: Optic nerve head evaluation
was not performed, reason not otherwise specified (2027F with 8P)