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  • IRIS38: Endothelial Keratoplasty - Dislocation Requiring Surgical Intervention

    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 Option: 

    • 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 endothelial keratoplasty patients with a rebubbling or revision or repair procedure within 90 days after surgery

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

    To Which Patients Does the Measure Apply?

    Denominator: Patients aged 18 years or older who underwent an endothelial keratoplasty surgery.

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

    1. Patient characteristics: Description located in “Denominator” (see above).
    2. Procedure codes (CPT): Codes located in “CPT Codes.” 

    The quality measure also has exclusions for the denominator

    CPT Codes

    Corneal graft procedure (CPT: 65756 with modifier RT, LT)

    How To Report the Measure

    Numerator: Patients with a surgical intervention within 90 days of endothelial keratoplasty surgery.

    Surgical intervention – rebubbling, revision or repair (CPT:  66020, 66250)

    Denominator Exclusions:

    • Adherent leukoma:  H17.01, H17.02, H17.03
    • Pupillary membranes:  H21.41, H21.42, H21.43
    • Adhesions and disruptions of iris and ciliary body: H21.501, H21.502,  H21.503
    • Anterior synechiae (iris): H21.511, H21.512, H21.513
    • Goniosynechiae: H21.521, H21.522, H21.523
    • Iridodialysis: H21.531, H21.532, H21.533,
    • Posterior synechiae (iris): H21.541, H21.542, H21.543,
    • Recession of chamber angle:  H21.551, H21.552, H21.553,
    • Pupillary abnormalities: H21.561, H21.562, H21.563
    • Other disorders of iris and ciliary body: H21.81, H21.82, H21.89,
    • Anterior chamber IOL
    • Aphakia: H27.01, H27.02, H27.03
    • Dislocation of lens: H27.10, H27.111, H27.112, H27.113, H27.121, H27.122, H27.123, H27.131, H27.132, H27.133
    • Hypotony of eye: H44.40, H44.411, H44.412, H44.413, H44.421, H44.422, H44.423, H44.431, H44.432, H44.433, H44.441, H44.442, H44.443
    • Open wound of eyeball: S05.11XA, S05.12XA, S05.21XA, S05.22XA, S05.31XA, S05.32XA, S05.41XA, S05.42XA, S05.51XA, S05.52XA, S05.61XA, S05.62XA, S05.71XA, S05.72XA, S05.8X1A, S05.8X2A, S05.91XA, S05.92XA
    • Prior glaucoma filtering surgery: CPT 66170, 66172, 66179, 66180, 66183, 66184, 66185
    • Prior pars plana vitrectomy: CPT 67036, 67039, 67040, 67041, 67042, 67043
    • Prior penetrating keratoplasty: CPT 65730, 65750, 65755

    How CMS Scores Your Performance

    See the QPP resource library for benchmarks.


    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. 


    © 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.