• Measure 12: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation


    Reporting Option: 

    • IRIS Registry EHR
    • EHR through your vendor
    • IRIS Registry group reporting
    • IRIS Registry manual data entry
    • Claims based reporting

    Measure Type: Process 

    CPT Codes:

    92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

    Without Telehealth modifier: GQ, GT

    Denominator note: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for registry-based measures.

    Diagnosis Codes:

    CMS has stated that ICD-10 should be coded to the greatest specificity and unspecified codes may be denied. Therefore the codes listed below with a strikethrough should not be included on your claim or submitted with this quality measure.

    Diagnosis for primary open-angle glaucoma: H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.1110, H40.1111, H40.1112, H40.1113, H40.1114, H40.1120, H40.1121, H40.1122, H40.1123, H40.1124, H40.1130, H40.1131, H40.1132, H40.1133, H40.1134, H40.1190, H40.1191, H40.1192, H40.1193, H40.1194, H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224, H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.1290H40.1291, H40.1292, H40.1293, H40.1294, H40.151, H40.152, H40.153, H40.159

    Clinical Recommendation Statements:  In completing the elements in the comprehensive adult medical eye evaluation, the ophthalmic evaluation specifically focuses on the following elements:

    • History [A:III]
    • Visual acuity measurement [A:III]
    • Pupil examination [B:II]
    • Anterior segment examination [A:III]
    • Intraocular pressure measurement [A:I]
    • Gonioscopy [A:III]
    • Optic nerve head and retinal nerve fiber layer examination [A:III]
    • Fundus examination [A:III]

    Claims Based and IRIS Registry Manual Reporting

    Instructions:  This measure is to be reported a minimum of once per reporting period for patients, aged 18 years and older, seen during the reporting period.  It’s anticipated that clinicians who provide the primary management of patients with primary open-angle glaucoma (in either one or both eyes) will submit this measure.

    Category II Codes:

    2027F   Optic nerve head evaluation performed; or

    2027F 1P   Documentation of medical reason(s) for not performing an optic nerve head evaluation; or

    2027F 8P   Optic nerve head evaluation was not performed, reason not otherwise specified

    IRIS Registry EHR Reporting

    Instructions:  Percentage of patients aged 18 years and older with a diagnosis of POAG who have been seen for at least 2 office visits, who have an optic nerve head evaluation during one or more office visits within 12 months.

    These are the required elements to be documented at least once a year to meet the measure performance requirements.

    • Cup to disc ratio
    • Structural abnormalities of the optic disc

    How CMS Scores Your Performance

    • If you report this measure for at least 50 percent of applicable patients during a reporting period, you will earn points based on the decile that corresponds to your performance rate. Not all measures offer points for every decile.
    • If you successfully report a measure for less than 50 percent of your patients, you will earn 3 points.

    You can also earn bonus points if you electronically report this measure (i.e., through an integrated EHR system).

    Decile/Points eCQM Benchmark (Integrated EHR) Web Portal Benchmark (No EHR)
    3 73.33 - 82.41 95.07 - 98.10
    4 82.42 - 87.39 98.11 - 99.35
    5 87.40 - 90.90 99.36 - 99.99
    6 90.91 - 94.16 --
    7 94.17 - 96.57 --
    8 96.58 - 98.25 --
    9 98.26 - 99.57 --
    10 >= 99.58 100