Updated December 2021. This measure is not approved for 2022. Changes for 2021 are indicated in red.
Care Setting: Ambulatory Care: Clinician Office/Clinic
- IRIS Registry QCDR for EHR: groups and individuals
- IRIS Registry QCDR manual data entry: groups and individuals
Measure Type: High Priority
NQS Domain: Effective Clinical Care
Meaningful Measure Area: Promote Effective Prevention & Treatment of Chronic Disease
Description: Percentage of patients aged 18 years and older who
underwent ocular oculoplastic surgical procedures who were assessed for opioid use/requirements post-operatively, defined by either not receiving opioids post-operatively, receiving opioids for pain for 7 days or less post-operatively, or if expected to require opioids for more than 7 days after the surgical procedure, having an opioid use management plan documented.
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 who underwent an ocular oculoplastic surgical procedure.
There are three criteria for inclusion of a patient into the denominator.
- Patient characteristics: Description located in “Denominator” (see above).
- Procedure codes (CPT): Codes located in “CPT ”
Ocular oculoplastic Surgery (CPT Codes: 67450, 67440, 67445, 67430, 67420, 67400,
67405, 67413, 67904, 31292, 31239, 21365, 21407, 21339, 21390, 15823, 15822, 21366,
21385, 21386. 21387, 21395, 21400, 21401, 21406, 21408, 67412, 67413, 67414, 65420,
65435, 65600, 65436, 65400, 65426 )
How to Report the Measure
Numerator: Percentage of patients aged 18 years and older who
underwent ocular oculoplastic surgical procedures who were assessed for opioid use/requirements post-operatively. The performance measure criteria can be met in the following circumstances:
- Patient did not receive a prescription for opioids post-operatively
- Patient received a prescription for opioids post-operatively for 7 days or less duration
- Patient received a prescription for opioids post-operatively for more than 7 days after the surgical procedure and had a documented opioid use management plan in the patient
How CMS Scores Your Performance
No scoring benchmark currently exists for this measure.
- If you successfully report a measure for less than 70% of your patients, you will earn points based on your practice size:
- Small practices (≤ 15 clinicians) will receive 3 points,
- Larger practices (> 15 clinicians) will receive 0
- If you successfully report a measure for at least 70% of your patients, but do not report at least 20 cases, you will receive 3
If at least 20 physicians report the measure on at least 70% of qualifying patients and at least 20 patients, CMS will develop a scoring benchmark using data collected during the 2020 reporting year.
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.