117. Diabetes: Eye Exam
Percentage of patients 18–75 years of age with diabetes who had a retinal or dilated eye exam by an eyecare professional during the measurement period or a negative retinal or dilated eye exam (no evidence of retinopathy)in the 12 months prior to the measurement period.
This measure is to be reported a minimum of once per performance period for patients with diabetes mellitus seen during the performance period. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on services provided and the measure-specific denominator coding.
Screen the patient for diabetes:
- Open the Ocular Exam.
- Select a dilated eye exam.
- Select a diabetes diagnosis from Impressions.
- Select a counseling Plan.
- Select the appropriate condition from the Quality 117 drop-down.
- Document the rest of the exam and Finalize.
Alternatively, code quality with a special plan:
- Open the Ocular Exam.
- Select a Diagnosis and Plan.
- Tap Special Plans and select MIPS.
- From Popular Plans, select MIPS Quality.
- Tap the Diabetes tab.
- Select the appropriate condition from the Quality 117 drop-down.
- Tap Done.
- Document the rest of the exam and Finalize.
Screen the patient for diabetes:
- In a patient’s exam record in ExamWRITER, record the office visit.
- Click the Exam - Special Tests tab.
- Click the Examination category bar.
- Select the Retina - Vascular check box and click Process.
- On the Retina/Vascular window, select the check boxes that correspond to the patient’s condition, select an eye, and click Process:
- DFE performed (Diabetic Patient)
- On the Impression/Retna-Vascular window, select the check boxes that correspond to the patient’s condition and click Process:
- DM, Type I w/ Complications
- Diabetes, Type II w/ Complications
- Low Risk Retinopathy
- Click Process.
Eyefinity products and documentation refer to the MIPS quality numbers. Other measure numbering systems are listed here for your reference.
Quality | 117 |
NQF | 0055 |
CMS | 131 |
- Claims
- EHR (ExamWRITER only)
- Registry (Eyefinity EHR only)
Reporting methods vary by measure and EHR system. For more information about how different measures and reporting methods are scored, refer to the topic that corresponds with your EHR:
Patients 18 to 75 years of age on date of encounter;
AND is diagnosed with diabetes:
ICD-10:
E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3599, E10.36, E10.37X1, E10.37X2, E10.37X3, E10.37X9, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59, E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.641, E10.649, E10.65, E10.69, E10.8, E10.9, E11.00, E11.01, E11.21, E11.22, E11.29, E11.311, E11.319, E11.3211, E11.3212, E11.3213, E11.3219, E11.3291, E11.3292, E11.3293, E11.3299, E11.3311, E11.3312, E11.3313, E11.3319, E11.3391, E11.3392, E11.3393, E11.3399, E11.3411, E11.3412, E11.3413, E11.3419, E11.3491, E11.3492, E11.3493, E11.3499, E11.3511, E11.3512, E11.3513, E11.3519, E11.3521, E11.3522, E11.3523, E11.3529, E11.3531, E11.3532, E11.3533, E11.3539, E11.3541, E11.3542, E11.3543, E11.3549, E11.3551, E11.3552, E11.3553, E11.3559, E11.3591, E11.3592, E11.3593, E11.3599, E11.36, E11.37X1, E11.37X2, E11.37X3, E11.37X9, E11.39, E11.40, E11.41, E11.42, E11.43, E11.44, E11.49, E11.51, E11.52, E11.59, E11.610, E11.618, E11.620, E11.621, E11.622, E11.628, E11.630, E11.638, E11.641, E11.649, E11.65, E11.69, E11.8, E11.9, E13.00, E13.01, E13.10, E13.11, E13.21, E13.22, E13.29, E13.311, E13.319, E13.3211, E13.3212, E13.3213, E13.3219, E13.3291, E13.3292, E13.3293, E13.3299, E13.3311, E13.3312, E13.3313, E13.3319, E13.3391, E13.3392, E13.3393, E13.3399, E13.3411, E13.3412, E13.3413, E13.3419, E13.3491, E13.3492, E13.3493, E13.3499, E13.3511, E13.3512, E13.3513, E13.3519, E13.3521, E13.3522, E13.3523, E13.3529, E13.3531, E13.3532, E13.3533, E13.3539, E13.3541, E13.3542, E13.3543, E13.3549, E13.3551, E13.3552, E13.3553, E13.3559, E13.3591, E13.3592, E13.3593, E13.3599, E13.36, E13.37X1, E13.37X2, E13.37X3, E13.37X9, E13.39, E13.40, E13.41, E13.42, E13.43, E13.44, E13.49, E13.51, E13.52, E13.59, E13.610, E13.618, E13.620, E13.621, E13.622, E13.628, E13.630, E13.638, E13.641, E13.649, E13.65, E13.69, E13.8, E13.9, O24.011, O24.012, O24.013, O24.019, O24.02, O24.03, O24.111, O24.112, O24.113, O24.119, O24.12, O24.13, O24.311, O24.312, O24.313, O24.319, O24.32, O24.33, O24.811, O24.812, O24.813, O24.819, O24.82, O24.83
SNOMED:
105401000119101, 106281000119103, 10754881000119104, 111552007, 1481000119100, 190330002, 190331003, 190368000, 190369008, 190372001, 190389009, 190390000, 190406000, 190407009, 190410002, 190411003, 190412005, 199223000, 199225007, 199226008, 199227004, 199228009, 199229001, 199230006, 199231005, 23045005, 237599002, 237600004, 237618001, 237627000, 28032008, 31321000119102, 313435000, 313436004, 314771006, 314772004, 314893005, 314902007, 314903002, 314904008, 359642000, 426705001, 427089005, 42954008, 44054006, 445260006, 46635009, 4783006, 51002006, 57886004, 59079001, 5969009, 609563008, 609564002, 609566000, 609567009, 609568004, 609569007, 709147009, 716362006, 71791000119104, 75524006, 75682002, 76751001, 81531005, 91352004, 9859006
AND who had a visit during the measurement period:
92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402, G0438, G0439
Denominator Exclusions
Patient is using hospice services any time during the measurement period:
G9714
Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following:
- A retinal or dilated eye exam by an eyecare professional in the measurement period
- A negative retinal or dilated eye exam (no evidence of retinopathy) by an eyecare professional in the year prior to the measurement period
Performance Met
Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed:
G2102
OR SNOMED 274798009
OR seven standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed:
G2103
OR eye imaging validated to match diagnosis from seven standard field stereoscopic photos results documented and reviewed:
G2104
OR low risk for retinopathy—no evidence of retinopathy in the prior year (this code may only be counted if the encounter occurred during the performance period):
3072F
Performance Not Met
Dilated eye exam was not performed, reason not otherwise specified:
G2102 with 8P
OR
G2103 with 8P
OR
G2104 with 8P