CMS 131 - Diabetes: Eye Exam
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CMS 131 / Quality ID #117
Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy overlapping the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period.
Denominator: | All patients aged 18-75 years of age at the start of the measurement period with diabetes with a visit during the measurement period.
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Denominator Exclusions: | If patient was in Hospice during the measurement period:
Exclude patients 66 and older who are living long term in an institution for more than 90 consecutive days during the measurement period:
Exclude patients 66 and older with advanced illness and frailty because it is unlikely that patients will benefit from the services being measured:
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Numerator: | Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period. And, diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period.
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Office Visit Documentation: |
Once all steps have been completed, the measure will be added to the Quality Measures 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. |
Measure type: | Process |
High Priority Measure: | No |
Telehealth Eligible: | Yes |