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 newly diagnosed amblyopic patients with one or more of the following:
- A corrected interocular (or if not reported, the uncorrected) visual acuity difference < 0.23 logMAR 3-12 months after first diagnosis of amblyopia
- An improvement in the corrected visual acuity of the amblyopic eye of 3 or more Snellen lines (> or = 0.30 logMAR) 3-12 months after first diagnosis of amblyopia
- A final visual acuity in the amblyopic eye equal to 20/30 or better (less than or equal to 0.18 logMAR) 3-12 months after first diagnosis of amblyopia
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 between 3 to 7 years at diagnosis of amblyopia with recognized visual acuity difference of greater than 0.29 logMAR between right and left eye (IOD criterion is to exclude bilateral ametropic amblyopia).
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.”
The quality measure also has exclusions for the denominator.
Diagnosis Codes
- Amblyopia (ICD-10: H53.001, H53.002, H53.003, H53.021, H53.022, H53.023, H53.031, H53.032, H53.033)
How to Report the Measure
Numerator: Patients with interocular visual acuity difference of < 0.23 logMAR* or an improvement of three or more Snellen lines (> or = 0.30 logMAR)** in the amblyopic eye or a final visual acuity in the amblyopic eye of 20/30 or better (< or = 0.18 logMAR)*** recorded between 3 and 12 months after first use of amblyopia diagnosis code
*Difference in visual acuity values between right and left eye (inter-eye)
**Difference between baseline and visual acuity at 3-12 months in the amblyopic eye (intra-eye)
***Absolute visual acuity, not a difference
Denominator Exclusions: Patients with diagnosis of deprivation amblyopia (ICD 10: H53.01), cataract (ICD –10: H26.01-.06), aphakia (ICD-10: H27.00, H27.01, H27.02, H27.03), or pseudophakia (ICD-10: Z96.1)
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.
© 2017-2023 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.