Updated December 2022. No changes for 2023.
The measure is approved for traditional MIPS submission pathway only.
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.
- Patient characteristics: Description located in “Denominator” (see above).
- 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.
© 2018-2023 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 2023 American Medical Association.