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.

The 2027F Category II code has been retired. Quality Measure 12 (POAG: Optic Nerve Evaluation) is no longer available for claims-based reporting.

Document the optic nerve evaluation:

  1. In a patient’s exam record in ExamWRITER, record the office visit.
  2. Document the cup-to-disc ratio:
    1. Click the Exam -Special Test tab or locate the Examination section on the Full View tab.
    2. Click any of the CD Ratio fields to evoke the slider.

    You must record the C/D ratio for each visit. A C/D ratio copied forward from a previous visit will not count positively toward this measure.

  3. Click the Exam - Special Tests tab.
  4. Click the Examination category bar.
  5. Select the Glaucoma check box, and click Process.

  6. In the ANTERIOR CHAMBER DEPTH window, select the appropriate check boxes for the conditions you observe and click Process. None of these conditions affect this measure.
  7. 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.

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

    A pop-up window prompts you for more refinement.

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

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

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.

This measure is capped at a maximum of 7 points based on performance.

 

Submission Method 3rd Decile 4th Decile 5th Decile 6th Decile 7th Decile 8th Decile 9th Decile 10th Decile
EHR 85.71– 90.80 90.81– 93.99 94.00– 96.25 96.26– 97.66 97.67– 98.69 98.70– 99.43 99.44– 99.99 100

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, 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.

Denominator Exclusions

Telehealth modifier:

GQ, GT, 95, POS 02, FQ, 93

Denominator Exceptions

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

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