• IRIS35: Improvement of Macular Edema in Patients with Uveitis


    Updated December 2021. No changes for 2022. Changes for 2021 are indicated in red.

    Care Setting: Ambulatory Care: Clinician Office/Clinic

    Reporting Options: 

    • IRIS Registry QCDR for EHR: groups and individuals
    • IRIS Registry QCDR manual data entry: groups and individuals

    Measure Type: Outcome

    NQS Domain: Effective Clinical Care

    Meaningful Measure Area: Management of Chronic Conditions

    Description: Percentage of patients with uveitis and macular edema with a reduction of 20% or greater in the central subfield thickness on OCT within 90 days after treatment.

    Risk Adjusted: No 
    Performance Rate: 1
    High Priority Measure: Yes 
    Inverse Measure: No
    Proportional Measure

    To Which Patients Does the Measure Apply?

    Denominator: Patients aged 18 years or older with uveitis who underwent treatment for macular edema.

    There are two criteria for inclusion of a patient into the denominator.

    1. Patient characteristics: Description located in “Denominator” (see above).
    2. Diagnosis codes (ICD-10-CM): Codes located in “Diagnosis Codes.”

    Diagnosis Codes

    Diagnosis of Uveitis:

    • Anterior uveitis
      • Primary iridocyclitis (H20.011, H20.012, H20.013)
      • Recurrent acute iridocyclitis (H20.021, H20.022, H20.023)
    • Intermediate uveitis (H30.21, H30.22, H30.23)
    • Panuveitis (H44.111, H44.112, H44.113)
    • Posterior uveitis
      • Exudative retinopathy (H35.021, H35.022, H35.023)
      • Retinal vasculitis (H35.061, H35.062, H35.063)
      • Unspecified focal chorioretinal inflammation (H30.001, H30.002, H30.003)
      • Focal chorioretinal inflammation, juxtapapillary (H30.011, H30.012, H30.013)
      • Focal chorioretinal inflammation of posterior pole (H30.021, H30.022, H30.023)
      • Focal chorioretinal inflammation, peripheral (H30.031, H30.032, H30.033)
      • Focal chorioretinal inflammation, macular or paramacular (H30.041, H30.042, H30.043)
        Unspecified disseminated chorioretinal inflammation (H30.101, H30.102, H30.103)
      • Disseminated chorioretinal inflammation posterior pole (H30.111, H30.112, H30.113)
      • Disseminated chorioretinal inflammation, peripheral (H30.121, H30.122, H30.123)
      • Disseminated chorioretinal inflammation, generalized (H30.131, H30.132, H30.133)
        Unspecified chorioretinal inflammation (H30.91, H30.92, H30.93)
      • Other chorioretinal inflammations (H30.891, H30.892, H30.893)
      • Harada’s disease (H30.811, H30.812, H30.813)
        Vogt-Koyanagi Syndrome (H20.821, H20.822, H20.823)

    AND

    Diagnosis of Macular Edema

    • Cystoid macular degeneration (H35.351, H35.352, H35.353)
    • Retinal edema (H35.81)

    How to Report the Measure

    Numerator: Patients with a 20% reduction or greater of central subfield thickness within 90 days of treatment initiation

    How CMS Scores Your Performance

    See the QPP resource library for benchmarks.

    Copyright

    This measure has been developed by the H. Dunbar Hoskins Jr. MD Center for Quality Eye Care of the American Academy of Ophthalmology. The measure is not a clinical guideline and does not establish a medical standard. It has not been tested in all possible applications.

    The measure, while copyrighted, can be reproduced and distributed with appropriate credit, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. The American Academy of Ophthalmology encourages use of the measure by other health care professionals, where applicable.

    Commercial use is defined as the sale, license or distribution of the measures for commercial gain, or incorporation of some or all of a measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Ophthalmology. Neither the Academy nor its members shall be responsible for any use of the measures. 

    THE MEASURE AND SPECIFICATIONS ARE PROVIDED “AS IS,” WITHOUT WARRANTY OF ANY KIND.

    © 2018-2022 American Academy of Ophthalmology. All rights reserved. Limited proprietary coding from Current Procedural Terminology (CPT®) is contained in the measure specifications. Users of this code set should obtain all necessary licenses. The Academy disclaims all liability for use or accuracy of the coding contained in these measure specifications. CPT® contained in the measures specifications is copyright 2022 American Medical Association.