CMS131v6 – Diabetes: Eye Exam

Patients 18-75 years of age with diabetes with a visit during the measurement period.

– NUMERATOR

Patients with an eye screening for diabetic retinal disease. This includes diabetic patients who had one of the following:

1. A retinal or dilated eye exam by an eye care professional in the measurement period
2. A negative retinal exam (no evidence of retinopathy) by an eye care professional in the year prior to the measurement period

– Denominator Exclusion: 

Exclude patients who were in hospice care during the measurement year.

For Denominator:

Patient 18-75 years of age with a visit during the measurement period and with an active diagnosis of diabetes is included in the denominator of this measure. Navigate to Patient > Provider Note > Diagnosis to record diabetes.

The documentation of the first encounter takes place when one visit code gets attached with the patient.

For Numerator:
Patients with an eye screening for diabetic retinal disease are included in the Numerator of this measure. This includes diabetic patients who had one of the following:

1. A retinal or dilated eye exam by an eye care professional in the measurement period (Patient > Clinical > Evaluations)
2. Or a negative retinal exam (no evidence of retinopathy) by an eye care professional in the year prior to the measurement period

To learn more about how to add Evaluations, click here.

For Denominator Exclusion: 

Exclude patients who were in hospice care during the measurement year. To document Inpatient encounter, navigate to Patient > Clinical > Evaluation