• IRIS48: Adult Surgical Esotropia: Postoperative alignment

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

    Care Setting: Ambulatory Care: Clinician Office/Clinic

    Reporting Option: 

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

    Measure Type: Outcome

    NQS Domain: Effective Clinical Care

    Meaningful Measure Area: Promote Effective Prevention & Treatment of Chronic Disease

    Description: Percentage of adult esotropia patients receiving surgical treatment with a posttreatment alignment of 12 prism diopters (PD) or less.

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

    To Which Patients Does the Measure Apply?

    Denominator: All patients aged 19 years or more who underwent a surgical procedure for esotropia.

    There are three 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.”
    3. Procedure codes (CPT): Codes located in “CPT Codes.” 

    The quality measure also has exclusions for the denominator.

    Diagnosis Codes

    • Esotropia (ICD-10: H50.00, H50.011, H50.012, H50.021, H50.022, H50.031, H50.032, H50.041, H40.042, H50.05, H50.06, H50.07, H50.08)
    • Intermittent esotropia (ICD-10: H50.30, H50.311, H50.312, H50.32)
    • Partially accommodative esotropia (ICD-10:  H50.43)
    • Divergence insufficiency (ICD-10: H51.8)
    • Sixth nerve palsy (ICD-10: H49.21, H49.22, H49.23)

    CPT Codes

    • Surgical intervention for esotropia (CPT: 67311, 67312)

    How to Report the Measure

    Numerator: Postoperative alignment of 12 PD or less recorded between 4 and 12 weeks after surgery.

    Note: If there are multiple prism diopter measurements, the lowest measurement (likely to be the Simultaneous Prism and Cover Test) is to be used

    Denominator Exclusions

    • Duane syndrome (ICD-10: H50.811, H50.812)
    • Scarring of extraocular muscles (CPT: 67322)


    • Must have alignment within 12 PD for at least one testing condition

    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. 


    © 2018-2022 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.