012. Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months. The EHR reporting method also requires and optic disc exam for structural abnormalities.

This measure is to be reported a minimum of once per performance period for patients seen during the performance period. It is anticipated that eligible clinicians who provide the primary management of patients with primary open-angle glaucoma (in either one or both eyes) will submit this measure.

Document the optic nerve evaluation:

  1. Open the Ocular Exam.
  2. Select a dilated exam.
  3. Select the appropriate findings on the Discs and Fundus tabs.
  4. Select POAG from Impressions.
  5. Select an optic nerve evaluation Plan.
  6. Document the findings.
  7. Tap Done.
  8. 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 POAG tab.
  6. Select an optic nerve evaluation outcome from the Quality 12 drop-down.
  7. Tap Done.
  8. Document the rest of the exam and Finalize.

Document the optic nerve evaluation:

  1. In a patient’s exam record in ExamWRITER, record the office visit.
  2. Click the Exam - Special Tests tab.
  3. Click the Examination category bar.
  4. Select the Glaucoma check box, and click Process.

  5. In the ANTERIOR CHAMBER DEPTH window, select the appropriate check boxes for the conditions you observe and click Process. None of these conditions do not affect this measure.
  6. In the OPTIC DISC EVALUATION window, select the appropriate check boxes for the conditions you observe, and click Process. Any of these conditions qualify for this measure.

  7. In the IMPRESSION/GLAUCOMA window, select the type of Glaucoma.

    A pop-up window prompts you for more refinement.

  8. Select the appropriate check box for the stage and severity of the glaucoma.

  9. Click Process.
  10. In the TREATMENT GLAUCOMA window, select the appropriate check boxes for the treatments, and click Process. None of these treatments affect this measure.

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

 

Quality 12
NQF 0086e
CMS 143
  • Claims
  • EHR (ExamWRITER only)
  • Registry (Eyefinity EHR only)
  • AAO IRIS

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 aged 18 years or older;

AND who had a diagnosis of primary open-angle glaucoma:

H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.1110, H40.1111, H40.1112, H40.1113, H40.1114, H40.1120, H40.1121, H40.1122, H40.1123, H40.1124, H40.1130, H40.1131, H40.1132, H40.1133, H40.1134, H40.1210, H40.1211, H40.1212, H40.1213, H40.1214, H40.1220, H40.1221, H40.1222, H40.1223, H40.1224, H40.1230, H40.1231, H40.1232, H40.1233, H40.1234, H40.151, H40.152, H40.153

AND who had a visit during the measurement period:

92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99242*, 99243*, 99244*, 99245*, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

CPT codes listed with an asterisk (*) are noncovered services under the Physician Fee Schedule and will not be counted toward the denominator in claims-based reporting.

Telehealth modifier:

GQ, GT, 95, POS 02

Documentation of medical reason(s) for not performing an optic nerve head evaluation:

2027F with 1P modifier

OR [for EHR reporting] documentation of medical reason(s) for not performing a cup-to-disc ratio evaluation or optic disc exam for structural abnormalities:

183932001, 183964008, 183966005, 216952002, 266721009, 269191009, 274512008, 31438003, 35688006, 371133007, 397745006, 407563006, 410534003, 410536001, 416098002, 416406003, 428119001, 445528004, 59037007, 62014003, 79899007

Patients who are included in the denominator;

AND who have an optic nerve head evaluation during one or more office visits within 12 months

Performance Met

Optic nerve head evaluation performed:

2027F

OR

[for EHR reporting] cup-to-disc ratio evaluation performed:

71484-0, 71485-7

AND [for EHR reporting] optic disc exam for structural abnormalities performed:

71486-5, 71487-3

Performance Not Met

Optic nerve head evaluation was not performed, reason not otherwise specified:

2027F with 8P modifier