| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, Registry | Process | No | Effective Clinical Care | Ophthalmology |
Measure Description
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or hemorrhage AND the level of macular degeneration severity 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 age-related macular degeneration (in either one or both eyes) will submit this measure.
Denominator
All patients aged 50 years and older with a diagnosis of AMD
Denominator Criteria (Eligible Cases):
Patients aged ≥ 50 years on date of encounter
AND
Diagnosis for age-related macular degeneration (ICD-10-CM): H35.30, H35.3110, H35.3111, H35.3112, H35.3113, H35.3114, H35.3120, H35.3121, H35.3122, H35.3123, H35.3124, H35.3130, H35.3131, H35.3132, H35.3133, H35.3134, H35.3190, H35.3191, H35.3192, H35.3193, H35.3194, H35.3210, H35.3211, H35.3212, H35.3213, H35.3220, H35.3221, H35.3222, H35.3223, H35.3230, H35.3231, H35.3232, H35.3233
AND
Patient encounter during the performance period (CPT): 92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
Telehealth Modifier: GQ, GT
Numerator
Patients who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months
Definitions:
Macular Thickening – Acceptable synonyms for “macular thickening” include: intraretinal thickening, serous detachment of the retina, pigment epithelial detachment or macular edema.
Severity of Macular Degeneration – Early, intermediate and advanced.
Numerator Options:
Performance Met: Dilated macular exam performed, including documentation of the presence or absence of macular thickening or hemorrhage AND the level of macular degeneration severity (2019F)
OR
Denominator Exception: Documentation of medical reason(s) for not performing a dilated macular examination (2019F with 1P)