499. Appropriate Screening and Plan of Care for Elevated Intraocular Pressure Following Intravitreal or Periocular Steroid Therapy

Percentage of patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant) who, within seven weeks following the date of injection, are screened for elevated intraocular pressure (IOP) with tonometry with documented IOP less than or equal to 25 mm Hg for injected eye OR if the IOP was greater than 25 mm Hg, a plan of care was documented.

This measure is to be submitted a minimum of once per performance period for denominator eligible cases as defined in the denominator criteria. This measure is intended to reflect the quality of services provided for patients who had an intravitreal or periocular corticosteroid injection. This measure may be submitted by MIPS-eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure specific denominator coding.

Code quality with a special plan:

  1. Document a Diagnosis and Plan as you normally would.
  2. Tap Special Plans and select MIPS.
  3. From Popular Plans, select MIPS Quality and tap Save.
  4. Locate the MIPS Quality plan and tap Resume.
  5. Tap the Ocular Steroid Therapy tab.
  6. Select the appropriate options from the Quality 499 drop-downs.
  7. Tap Done.
  8. Document the rest of the visit and Finalize.

Eyefinity products and documentation refer to the MIPS quality numbers. Other measure numbering systems are listed here for your reference.

Quality 499
NQF —
CMS —
  • Registry
  • AAO IRIS
  • MVP

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 53.16– 63.88 63.89– 70.44 70.45– 76.26 76.27– 80.64 80.65– 84.84 84.85– 89.65 89.66– 94.93 ≥ 94.94
AAO IRIS — — — — — — — —
MVP — — — — — — — —

Number of patients, regardless of age, who had one or more visits during the measurement period:

92002, 92004, 92012, 92014, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245

AND who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant):

M1324

Denominator Exclusions

Patients with a diagnosis of hypotony:

M1326

OR Encounters conducted via telehealth:

M1426

Denominator Exceptions

Patients who were not seen for reasons documented by clinician for patient or medical reasons (for example, inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six months and had a subsequent IOP evaluation with IOP less than 25mm Hg within seven weeks of treatment):

M1325

If the intravitreal or periocular corticosteroid injection occurs between November 12 and December 31 of the performance period and the patient is not able to be seen for follow-up within the performance period, it would be appropriate to report the denominator exception for inadequate time for follow-up.

Number of patients who, within seven weeks following the date of injection, are screened for elevated intraocular pressure (IOP) with tonometry with documented IOP less than or equal to 25 mm Hg for injected eye listed in chart or if the IOP was greater than 25 mm Hg, a plan of care was documented.

Performance Met

Patients seen within seven weeks following the date of injection AND are screened for elevated intraocular pressure (IOP) with tonometry with documented IOP less than or equal to 25 mm Hg for injected eye:

M1322

OR patients seen within seven weeks following the date of injection AND are screened for elevated intraocular pressure (IOP) with tonometry with documented IOP greater than 25 mm Hg AND a plan of care was documented:

M1323

Performance Not Met

Patients who were not seen within seven weeks following the date of injection for follow up OR who did not have a documented IOP OR no plan of care documented if the IOP was greater than25 mm Hg:

M1321