NQF 0088 - (Additional) Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Measure: NQF 0088 (Alternate Core Measurement)
Measure Title: Diabetic Retinopathy: Documentation of presence or absence of macular rdema and level of Severity of Retinopathy
Measure Description: Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months.
*REQUIRED FOR MEANINGFUL USE (MU): Click here to view the Meaningful Use Criteria.
Quality Measure Documentation Workflow
1. The patient must be 18 years of age or older and have at least one face-to-face encounter with the provider during the reporting period.
2. A diagnosis of Diabetic Retinopathy (recorded by using any of the ICD9 codes listed below) must be recorded in the patient's Summary Active Problems field or encounter Assessment field:
362.01, 362.02, 362.03, 362.04, 362.05, 362.06.
3. Documentation to record patients that had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months. This can be documented by inserting the shortcut code "PQRIdmEYE" in the encounter Plan field or Summary Interventions field and using code: 2022F (Eye exam, dialated, by eye doctor documented/reviewed).
Measure Calculation Details
Numerator Calculation:
The numerator for this measure is calculated based on the following:
1. The number of patients in the denominator that also have documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months. This can be documented by inserting the shortcut code "PQRIdmEYE" in the encounter Plan field or Summary Interventions field and using code:
- 2022F (Eye exam, dialated, by eye doctor documented/reviewed)
Denominator Calculation:
The denominator for the measure is calculated based on the following:
1. The patient must be 18 years of age or older and have at least one face-to-face encounter with the provider during the reporting period.
2. And have a diagnosis of Diabetic Retinopathy (recorded by using one of the ICD9 codes listed below) must be recorded in the patient's Summary Active Problems field OR encounter Assessment field:
- 362.01, 362.02, 362.03, 362.04, 362.05, 362.06
Report Clinical Quality Measures to CMS/State
All of the items listed in the above steps need to be documented as structured data (as detailed above) in order to allow the user to capture the numerator, denominator and percentage for this quality measure.
For information on how to export the numerator, denominator and percentage for each Clinical Quality Measure, click here.
For more information on reporting clinical quality measures, click here.