CMS 142 - Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Overview

CMS142v8 (2020)

CMS142v9 (2021)

CMS142v10 (2022)

Identifiers

CMS eCQM IDNQF eCQM IDNQFMIPS Quality ID
CMS142v10019

*MIE only supports data collection and reporting using eCQM specifications

Definitions

DescriptionPercentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months
Initial Patient PopulationAll patients aged 18 years and older with a diagnosis of diabetic retinopathy
DenominatorEquals Initial Population who had a dilated macular or fundus exam performed
Denominator Exclusions
NumeratorPatients with documentation, at least once within 12 months, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient's diabetic care
Numerator Exclusions
Denominator Exceptions
  • Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes.
  • Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes.

Additional Information

Measure TypeProcess measure
Measure ScoringProportion measure
GranularityPatient
Improvement NotationHigher score indicates better quality
DomainCommunication and Care Coordination

Clinical Instructions

New UI Visit Encounter (valid RC202109+)

Original Visit Encounter

Evidence

Initial Patient Population

NameValue Set
Diagnosis: Diabetic Retinopathy2.16.840.1.113883.3.526.3.327
Encounter, Performed: Care Services in Long-Term Residential Facility2.16.840.1.113883.3.464.1003.101.12.1014
Encounter, Performed: Nursing Facility Visit2.16.840.1.113883.3.464.1003.101.12.1012
Encounter, Performed: Office Visit2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Ophthalmological Services2.16.840.1.113883.3.526.3.1285
Encounter, Performed: Outpatient Consultation2.16.840.1.113883.3.464.1003.101.12.1008

Denominator

NameValue Set
Diagnostic Study, Performed: Macular Exam2.16.840.1.113883.3.526.3.1251

Numerator

NameValue Set
Communication, Performed: Level of Severity of Retinopathy Findings2.16.840.1.113883.3.526.3.1283
Communication, Performed: Macular edema absent (situation)SNOMEDCT Code 428341000124108
Communication, Performed: Macular Edema Findings Present2.16.840.1.113883.3.526.3.1320

Denominator Exceptions

NameValue Set
Communication, Not Performed: Level of Severity of Retinopathy Findings2.16.840.1.113883.3.526.3.1283
Communication, Not Performed: Macular edema absent (situation)SNOMEDCT Code 428341000124108
Communication, Not Performed: Macular Edema Findings Present2.16.840.1.113883.3.526.3.1320

Source(s)

eCQI CMS142


WebChart Documentation

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