Updated December 2022. No changes for 2023.
The measure is approved for traditional MIPS submission pathway only.
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: Outcome
NQS Domain: Effective Clinical Care
Meaningful Measure 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 minimally invasive glaucoma surgery and achieved 20/30 best-corrected distance visual acuity or better OR an improvement in best-corrected distance visual acuity within 4 months following the cataract surgery. Weighted average of performance rates reported.
Risk Adjusted: No
Performance Rate: 1
High Priority Measure: Yes
Inverse Measure: No
To Which Patients Does the Measure Apply?
Denominator: Eyes of patients aged 18 years and older who underwent a cataract surgery procedure and minimally invasive glaucoma surgery on the same date.
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.”
- Cataract Surgery
CPT Codes: 66987, 66988, 66989, 66991
Modifier -55 (Postoperative management only) OR Modifier -56 (Preoperative management only)
How to Report the Measure
Numerator: 20/30 best-corrected distance visual acuity OR an improvement in best-corrected distance visual acuity achieved within 4 months following the cataract surgery:
Eyes with mild to moderate stage glaucoma and a 20/30 or better post-operative best-corrected distance visual acuity
Eyes with severe stage glaucoma or a pre-operative best-corrected visual acuity of 20/200 and a 2 lines or better improvement in the post-operative best-corrected distance visual acuity from preoperative visual acuity
Eyes with a pre-operative best-corrected visual acuity of 20/400 and a 1 line or better improvement in the post-operative best-corrected distance visual acuity from pre-operative visual acuity
- Eyes with absolute glaucoma blindness (ICD-10: H44.511, H44.512, H44.513)
- Eyes with these visual acuity findings: Count fingers (CF or FC), Hand motion (HM), Light perception (LP), No light perception (NLP)
This measure is to be calculated each time a procedure for cataracts and a procedure for MIGS is performed during the reporting period. This measure is intended to reflect the quality of services provided for the eyes receiving cataract surgery and MIGS on the same day.
- Include only procedures performed through August 31 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
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.
THE MEASURE AND SPECIFICATIONS ARE PROVIDED “AS IS,” WITHOUT WARRANTY OF ANY KIND.
© 2021-23 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.