Updated December 2024. No changes for 2024.
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 Measures Area: Management of Chronic Conditions
Description: Percentage of eyes of patients aged 18 years and older with a diagnosis of cataract who had cataract surgery and had the following complications within 90 days after cataract surgery: prolonged inflammation, incision complications, iris complications, retinal detachment, cystoid macular edema, corneal complications or return to the operating room.
Risk Adjusted: No
Performance Rate: 1
High Priority Measure: Yes
Inverse Measure: Yes
Proportional Measure
To Which Patients Does the Measure Apply?
Denominator: Eyes of patients aged 18 years and older with a diagnosis of cataract who had cataract surgery.
- This measure is to be calculated each time a procedure for uncomplicated cataracts is performed during the reporting period. This measure is intended to reflect the quality of services provided for the patients receiving cataract surgery.
- Include only procedures performed through Sept. 30 of the reporting period. This will allow the postoperative period to occur within the reporting year.
- Clinicians who indicate modifier 55, postoperative management only OR modifier -56, preoperative management only, will not qualify for this measure
There are two criteria for inclusion of a patient into the denominator.
- Patient characteristics: Description located in “Denominator” (see above)
- Procedure codes (CPT): Codes located in “CPT Codes”
CPT Codes
66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984, 66987, 66988
How To Report the Measure
Numerator: Eyes of patients aged 18 years and older with a diagnosis of cataract who had cataract surgery and had the following complications within 90 days after cataract surgery: prolonged inflammation, incision complications, iris complications, retinal detachment, cystoid macular edema, corneal complications or return to the operating room.
Lower rate indicates better performance.
ICD-10 Codes
T85.79XA, T81.31XA, H20.051, H20.052, H20.053, H21.531, H21.532, H21.533, H21.561, H21.562, H21.563, H33.012, H33.013, H33.021, H33.022, H33.023, H33.031, H33.032, H33.033, H33.041, H33.042, H33.043, H33.051, H33.052, H33.05, H59.031, H59.032, H59.033, H18.11, H18.12, H18.13, H18.231, H18.232, H18.233
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.
© 2017-2024 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.