CMS Measure ID: #303
Collection Type: CQM
Reporting Frequency: Every Visit
Outcome: Yes
High Priority: Yes
NQS Domain: Communication and Care Coordination
Measure Age: > 2 years
Instructions
This measure is to be submitted 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 the Merit-based Incentive Payment System (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 surgery.
- 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 surveys.
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.
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.
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, 66987, 66988
WITHOUT
Modifier: 55 or 56
WITHOUT
Telehealth Modifier (including but not limited to): GQ, GT, 95, POS 02
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)