This article covers the Clinical Quality Measure Report "Diabetes: Eye Exam". This report is used to meet Clinical Quality Measure requirements for MIPS and Medicaid reporting programs. We'll cover the structure of the report and how it works so you can meet your Clinical Quality Measure requirements.
Overview of Measure
The "Diabetes: Eye Exam" report identifies the percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period.
A patient will be in the denominator when they have all of the following:
- An age between 18 and 75 years old
- A visit during your reporting period
- A Diabetes diagnosis with an Onset Date prior to the visit's Procedure Date. This diagnosis must be for Type 1 or Type 2 Diabetes.
A patient will be excluded from the denominator when:
- Only a diagnosis of secondary diabetes due to another condition. The denominator only looks for patients with a diagnosis of Type 1 and Type 2 diabetes.
- If the patients have hospice care that overlaps the reporting period.
- If the patient is 66 years of age or older who is living in a long term institution for at least 90 days in the reporting period.
- If the patient is 66 years of age or older who has been diagnosed with an advanced illness or frailty.
A patient will be in the numerator when they have all of the following:
- A Retinal or Dilated Eye Exam added to their EHR form in the CQM Supplemental section section with a Start Date and End Date that matches the date of the visit.
- This Eye Exam must be performed by an ophthalmologist or optometrist provider.
- Filter Providers: This filter allows you to narrow the generated data to include and exclude specific providers. When checked, any selected providers will be included in the results.
- Filter Offices: This filter allows you to narrow the generated data to include and exclude specific Office references.
- Filter Ethnicities: This filter will allow you to narrow the generated results to specific ethnicities as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
- Filter Races: This filter will allow you to narrow the generated results to specific races as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
- Filter Sex: This filter will allow you to narrow the generated results to specific genders as designated by the "Sex" field in the Patients Ability > Patient Tab > Sex drop down menu.
- Filter Insurances: This filter allows you to narrow down results to patients that have the selected insurances added in the Patients Ability > Patient Tab > Insurance Sub-Tab.
- Filter Tax Identification Numbers: This filters narrows results based on the provider's Tax ID numbers. In this case, it will narrow down to patients with the associated providers.
- Filter National Provider Identifiers: This filters narrows results based on the provider's National Provider Identifier (NPI). In this case, it will narrow down to patients with the associated providers.
- Filter Provider Types: This filter will narrow results by the Provider Taxonomy codes present in References > User > Provider Tab > Provider Taxonomy. To be precise, it will narrow the results to patients associated with providers with the selected Taxonomy codes entered in the User Reference.
- Filter Problem Lists: This filter will narrow the results down to patients who have the selected diagnosis codes entered into their Problem Lists. You can find these in the Clinical Ability under the Problem List widget.
- Filter Practice Address: This filter will narrow results down to patients who are associated with the Office with an address that matches the selected address.
- Start/End Date: These fields allow you to narrow the range of the generated results to the specified date range.
- Start Age/End Age: These drop downs allow you to narrow results down to patients with ages in between the range.
- Group Name: For reports with multiple numerator requirements, this identifies the numerator that is being checked for. In this report's case, there is only one numerator requirement.
- Numerator: The number of patient that meet the numerator requirements described above.
- Denominator: The number of patients that meet the denominator requirements described above.
- Percentage: The percentage of patients meeting both the numerator and denominator requirements.
- Patient #: The Patient Account Number for the Patient in question.
- Patient Name: The name of the patient in question, formatted as last name/first name.
- In Numerator (Yes/No): This column identifies whether the patient in question meets the numerator requirements.