Skip to main content

Comprehensive Diabetes Care: Eye Exam (retinal) performed

CBE ID
0055
Endorsement Status
E&M Committee Rationale/Justification

Steward is no longer seeking endorsement. 

1.0 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.6 Measure Description

The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who had an eye exam (retinal) performed.

    Measure Specs
      General Information
      1.7 Measure Type
      1.3 Electronic Clinical Quality Measure (eCQM)
      1.9 Care Setting
      1.14 Numerator

      Patients who received an eye screening for diabetic retinal disease. This includes people with diabetes who had the following:
      -a retinal or dilated eye exam by an eye care professional (optometrists or ophthalmologist) in the measurement year
      –a negative retinal exam or dilated eye exam (negative for retinopathy) by an eye care professional in the year prior to the measurement year.
      -Bilateral eye enucleation anytime during the patient’s history through December 31 of the measurement year

      For exams performed in the year prior to the measurement year, a result must be available.

      1.15 Denominator

      Patients 18-75 years of age by the end of the measurement year who had a diagnosis of diabetes (type 1 or type 2) during the measurement year or the year prior to the measurement year.

      Exclusions

      Exclude patients who use hospice services or elect to use a hospice benefit any time during the measurement year, regardless of when the services began.

      Exclusions (optional):
      -Exclude patients who did not have a diagnosis of diabetes, in any setting, AND who had a diagnosis of gestational or steroid-induced diabetes, in any setting, during the measurement year or the year prior to the measurement year
      -Exclude patients 65 and older with an advanced illness condition and frailty

      Most Recent Endorsement Activity
      Endorsed Primary Care and Chronic Illness Spring Cycle 2018
      Initial Endorsement
      Last Updated
      Removal Date
      Steward Organization
      National Committee for Quality Assurance
      Steward POC email
      Steward Organization Copyright

      The performance measures and specifications were developed by and are owned by the National Committee for Quality Assurance
      (“NCQA”). The performance measures and specifications are not clinical guidelines and do not establish a standard of medical care.
      NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports
      performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in
      these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than
      NCQA. Anyone desiring to use or reproduce the materials without modification for an internal, quality improvement non-commercial
      purpose may do so without obtaining any approval from NCQA. All other uses, including a commercial use and/or external
      reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA.
      ©2018 NCQA, all rights reserved.
      Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should
      obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding
      contained in the specifications.
      Content reproduced with permission from HEDIS, Volume 2: Technical Specifications for Health Plans. To purchase copies of this publication, including the full measures and specifications, contact NCQA Customer Support at 888-275-7585 or visit
      www.ncqa.org/publications.

                Public Comments