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Clinical Quality Measures

CMS167 - Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

Measure Description: Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months

Denominator: All patients aged 18 years and older with a diagnosis of diabetic retinopathy

Numerator: Patients who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy AND the presence or absence of macular edema during one or more office visits within 12 months

Measure Calculation in ChARM EHR: MANUAL

This measure is calculated based on the actions recorded under 'Encounter > MU' section.

To satisfy this measure, for patient with Age >= 18 years with an active diagnosis of 'Diabetic Retinopathy’ (Example ICD 10 codes : E08.311,E08.3213, E08.3411 ), Macular Exam Study should be performed and the level of Severity of Retinopathy should be recorded. Also, presence or absence of Macular Edema should be recorded under 'Encounter > MU' section.
Macular Edema

Denominator Exception: Patients will be manually exempted based on other conditions listed below in 'Encounter > MU' section.
Macular Edema Exception