Diabetes: Eye Exam

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Updated: 06/15/2020
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Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal or dilated eye exam (no evidence of retinopathy) in the 12 months prior to the measurement period.

Denominator:	All patients aged 18-75 years of age with diabetes with a visit during the measurement period. Patient’s age is calculated based on the patient’s Date of Birth, which is entered when you created the patient’s account. The diagnosis of "Diabetes" is entered in the patient’s Problem List. Make sure to add a Start Date to the problem.
Denominator Exclusions:	Exclude patients whose hospice care overlaps the measurement period.
Numerator:	Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: A retinal or dilated eye exam by an eye care professional in the measurement period or a negative retinal or dilated exam (no evidence of retinopathy) by an eye care professional in the year prior to the measurement period. "Diabetic Eye Exam (Age 18-75): Eye exam performed" is documented under Care Checklist on the date that it was discussed with the patient which should be the date of the note.
Office Visit Documentation:	Create a note detailing the patient’s office visit. Enter Procedure Codes including E/M Codes or CPT/HCPCS Codes on the Superbill. Complete and sign the note. Once all steps have been completed, the measure will be added to the Quality Report.
Guidance:	Only patients with Type 1 or Type 2 diabetes will be included. Patients with a diagnosis of secondary diabetes due to another condition will not be included. The eye exam must be performed by an ophthalmologist or optometrist.
Quality ID:	117
CMS Measure ID:	CMS131
Measure type:	Process
High Priority Measure:	No