2021 MIPS Measure #303: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery

Measure Description

Percentage of patients aged 18 years and older who had cataract surgery and had improvement in visual function achieved within 90 days following the cataract surgery, based on completing a pre-operative and post-operative visual function survey

Instructions

This measure is to be calculated each time a procedure for cataracts is performed during the performance period. This measure is intended to reflect the quality of services provided for the patient receiving cataract surgery.

Note: This is an outcome measure and will be calculated solely using MIPS eligible clinician, group, or third party intermediary submitted data.

• For patients who receive the cataract surgical procedures specified in the denominator coding, it should be submitted whether or not the patient had improvement in visual function achieved within 90 days following the cataract
• Only procedures performed through September 30 of the performance period are eligible for the denominator. This will allow the post-operative period to occur before third party intermediaries must submit data to CMS.
• It is the responsibility of the third party intermediary to collate and score the

Measure Submission Type:

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third-party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third-party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

Denominator

All patients aged 18 years and older who had cataract surgery

Denominator Criteria (Eligible Cases):

Patients aged ≥ 18 years on date of encounter

AND

Patient procedure during the performance period (CPT): 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984

WITHOUT

Modifier: 55 or 56

Numerator

Patients 18 years and older who had improvement in visual function achieved within 90 days following cataract surgery, based on completing a pre-operative and post-operative visual function survey

NUMERATOR NOTE: Denominator Exception(s) are determined within 90 days of the date of the denominator eligible procedure.

Numerator Options:

Performance Met: Improvement in visual function achieved within 90 days following cataract surgery (G0913)

OR

Denominator Exception: Patient care survey was not completed by patient (G0914)

OR

Performance Not Met: Improvement in visual function not achieved within 90 days following cataract surgery (G0915)