019. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

Examine the macula and fundus:

1. Open the Ocular Exam.
2. Select a dilated macular or fundus exam.
3. Select diabetic retinopathy from Impressions.
4. Tap ICD-10 Exp on the right side of the screen.
5. Select the appropriate conditions from the Severity and Macular Edema drop-downs.
6. Select a counseling Plan.
7. Tap the Diabetic Retinopaty tab.
8. Select the appropriate communication from the Quality 19A or Quality 19B drop-downs.
9. Tap Done.
10. Document the rest of the exam and Finalize.

Alternatively, code quality with a special plan:

1. Open the Ocular Exam.
2. Select a Diagnosis and Plan.
3. Tap Special Plans and select MIPS.
4. From Popular Plans, select MIPS Quality.
5. Tap the Diabetic Retinopathy tab.
6. Select the appropriate communication from the Quality 19A or Quality 19B drop-downs.
7. Tap Done.
8. Document the rest of the exam and Finalize.

• Registry
• AAO IRIS

This topic describes how points are calculated for this measure. To learn more about scoring, go to Scoring.

Benchmarks are displayed here as both a chart and a table. The chart gives you a visual representation and helps you quickly compare benchmarks across different reporting methods. The table lists the specific benchmark criteria for each available reporting method.

 

Submission Method	3rd Decile	4th Decile	5th Decile	6th Decile	7th Decile	8th Decile	9th Decile	10th Decile
Registry	97.83– 99.99	—	—	—	—	—	—	100
AAO IRIS	91.45– 98.70	98.71– 99.99	—	—	—	—	—	100.00

Patients aged 18 years or older;

AND is diagnosed with diabetic retinopathy:

AND who had a visit during the measurement period:

AND who had dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema AND level of severity of retinopathy:

Denominator Exclusions

Telehealth modifier:

Place of service modifier:

Denominator Exceptions

Documentation of medical reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician or other qualified health care professional managing the ongoing care of the patient with diabetes:

OR

Documentation of patient reason(s) for not communicating the findings of the dilated macular or fundus exam to the physician or other qualified health care professional managing the ongoing care of the patient with diabetes:

Patients with documentation, at least once within the performance period, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient’s diabetic care.

Performance Met

Findings of dilated macular or fundus exam communicated to the physician or other qualified health care professional managing the diabetes care:

Performance Not Met

Findings of dilated macular or fundus exam were not communicated to the physician or other qualified health care professional managing the diabetes care, reason not otherwise specified: