Mdinteractive.co2

SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
CATARACTS MEASURES GROUP OVERVIEW
2013 PQRS OPTIONS FOR MEASURES GROUPS:
REGISTRY ONLY

2013 PQRS MEASURES IN CATARACTS MEASURES GROUP:

#191. Cataracts: 20/40 or Bet er Visual Acuity within 90 Days Fol owing Cataract Surgery #192. Cataracts: Complications within 30 Days Fol owing Cataract Surgery Requiring Additional Surgical #303. Cataracts: Improvement in Patient’s Visual Function within 90 Days Fol owing Cataract Surgery #304. Cataracts: Patient Satisfaction within 90 Days Fol owing Cataract Surgery
INSTRUCTIONS FOR REPORTING: (These instructions apply to registry reporting. Do not report this
measures group via claims.)
� It is not necessary to submit the measures group-specific intent G-code for registry-based submissions. However, the measures group-specific intent G-code has been created for registry only measures groups for use by registries that utilize claims data. G8906: I intend to report the Cataracts Measures Group
20 Patient Sample Method: 20 unique procedures (patients – a majority of which must be
Medicare P art B FFS [fee for service] patients) meeting patient sample criteria for the measures group during the reporting period (J anuary 1 through December 31, 2013 OR J uly 1 through
� Patient sample criteria for the Cataracts Measures Group are patients aged 18 years and older that have a specific procedure for cataract surgery performed: One of the fol owing procedure codes indicating cataract surgery: 66840, 66850, 66852,
Modifier 56 (preoperative management only)
� For purposes of satisfactory reporting al measures contained within the Cataracts Measures
Group, include only procedures performed through September 30 of the reporting period. P rocedures performed October 1 through December 31 of the reporting period are not included. � Measures #191 and #192 need only be reported when the patient also has a diagnosis of uncomplicated cataract. Refer to the measure specification on the fol owing pages for specific codes indicating a diagnosis of uncomplicated cataract for each of these two measures. Measures #303 and #304 need not be reported when the cataract surgery includes a modifier 55 (post-
� Report a numerator option on al applicable measures within the Cataracts Measures Group for
each procedure (patient) within the eligible professional’s patient sample. � Instructions for qualifying numerator option reporting for each of the measures within the Cataracts Measures Group are displayed on the next several pages. The fol owing composite G-code has been created for registry only measures groups for use by registries that utilize claims data. This composite G-code may be reported in lieu of the individual quality-data codes for each of the measures within the group, if al quality actions for the patient have been performed for al the Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
measures within the group. However, it is not necessary to submit the fol owing composite G-code
Composite G-code G8765: Al quality actions for the applicable measures in the Cataracts
Measures Group have been performed for this patient � To report satisfactorily the Cataracts Measures Group it requires al applicable measures for each
patient within the eligible professional’s patient sample to be reported each time a cataract surgery is performed during the reporting period. � Measures groups containing a measure with a 0% performance rate wil not be counted as satisfactorily reporting the measures group. The recommended clinical quality action must be performed on at least one patient for each measure within the measures group reported by the eligible professional. P erformance exclusion quality-data codes are not counted in the performance denominator. If the eligible professional submits al performance exclusion quality-data codes, the performance rate would be 0/0 and would be considered satisfactorily reporting. If a measure within a measures group is not applicable to a patient, the patient would not be counted in the performance denominator for that measure (e.g., P reventive Care Measures Group - Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older would not be applicable to male patients according to the patient sample criteria). If the measure is not applicable for al patients within the sample, the performance rate would be 0/0 and would be considered satisfactorily reporting. When a lower rate indicates bet er performance, such as Measure #192, a 0% performance rate wil be counted as satisfactorily reporting (100% performance rate would not be considered satisfactorily reporting). � When using the 20 Patient Sample Method, report al applicable measures for the 20 unique procedures performed (patients seen) a majority of which must be Medicare P art B FFS procedures (patients) for the 12-month or 6-month reporting period. NOTE: The detailed instructions in this specification apply exclusively to the reporting and analysis of the included measures under the measures groups option. For al other claims-based or registry-based reporting options, please see the measures’ ful specifications in the document “2013 P hysician Quality Reporting System (P QRS) Measure Specifications Manual for Claims and Registry Reporting for Individual Measures” available for download from the CMS P QRS website Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Measure #191 (NQF 0565): Cataracts: 20/40 or Better Visual Acuity within 90 Days Fol owing
Cataract Surgery

DESCRIPTION:

P ercentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best- corrected visual acuity of 20/40 or bet er (distance or near) achieved within 90 days fol owing the cataract
Note: This is an outcomes measure and can be calculated solely using registry data.
� For patients who receive the cataract surgical procedures specified in the common denominator coding, it should be reported whether or not the patient had best-corrected visual acuity of 20/40 or bet er achieved within 90 days fol owing cataract surgery. � Patients who have any of the listed comorbid conditions in the exclusion criteria should be removed from the denominator; these patients have existing ocular conditions that could impact the outcome of surgery and are not included in the measure calculation for those patients who have best-corrected visual acuity of 20/40 or bet er (distance or near) achieved within 90 days fol owing the cataract surgery. � Include only procedures performed through September 30 of the reporting period. This wil
al ow the post operative period to occur within the reporting year. (P atients with documentation of any of the fol owing comorbid conditions that impact the visual outcome of surgery prior to date of cataract surgery are excluded from the measure calculation) Comorbid Condition
Corresponding ICD-9-CM Codes
364.00, 364.01, 364.02, 364.03, 364.04, 364.05 940.0, 940.1, 940.2, 940.3, 940.4, 940.5, 940.9 371.20, 371.21, 371.22, 371.23, 371.43, 371.44 362.50, 362.51, 362.52, 362.53, 362.54, 362.55, 362.56, 362.01, 362.02, 362.03, 362.04, 362.05, 362.06 363.10, 363.11, 363.12, 363.13, 363.14, 363.15 Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-9-CM Codes
363.00, 363.01, 363.03, 363.04, 363.05, 363.06, 363.07, 365.10, 365.11, 365.12, 365.13, 365.14, 365.15, 365.20, 365.21, 365.22, 365.23, 365.24, 365.31, 365.32, 365.51, 365.52, 365.59, 365.60, 365.61, 365.62, 365.63, 365.64, 365.41, 365.42, 365.43, 365.44, 365.60, 365.61, 365.62, Congenital Anomalies, Dystrophies, 365.63, 365.64, 365.65, 365.81, 365.82, 365.83, 365.89, 371.50, 371.51, 371.52, 371.53, 371.54, 371.55, 371.56, 363.50, 363.51, 363.52, 363.53, 363.54, 363.55, 363.56, 362.70, 362.71, 362.72, 362.73, 362.74, 362.75, 362.76 Injury to Optic Nerve and Pathways 950.0, 950.1, 950.2, 950.3, 950.9 Moderate or Severe Impairment, 369.10, 369.11, 369.12, 369.13, 369.14, 369.15, 369.16, Lesser Eye Nystagmus and Other Irregular Eye 379.51 871.0, 871.1, 871.2, 871.3, 871.4, 871.5, 871.6, 871.7, 377.10, 377.11, 377.12, 377.13, 377.14, 377.15, 377.16 377.30, 377.31, 377.32, 377.33, 377.34, 377.39 Other Background Retinopathy and 362.12, 362.16, 362.18 Retinal Vascular Changes Other Corneal Deformities 362.20, 362.21, 362.22, 362.23, 362.24, 362.25, 362.26, 362.81, 362.82, 362.83, 362.84, 362.85, 362.89 Chorioretinitis and Retinochoroiditis P athologic Myopia 369.00, 369.01, 369.02, 369.03, 369.04, 369.05, 369.06, 361.00, 361.01, 361.02, 361.03, 361.04, 361.05, 361.06, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H20.00, H20.011, H20.012, H20.013, H20.019, H20.021, H20.022, H20.023, H20.029, H20.031, H20.032, H20.033, H20.039, H20.041, H20.042, H20.043, H20.049, H20.051, H53.011, H53.012, H53.013, H53.019, H53.021, H53.022, H53.023, H53.029, H53.031, H53.032, H53.033, H53.039 T26.00XA, T26.01XA, T26.02XA, T26.10XA, T26.11XA, T26.12XA, T26.20XA, T26.21XA, T26.22XA, T26.30XA, T26.31XA, T26.32XA, T26.40XA, T26.41XA, T26.42XA, T26.50XA, T26.51XA, T26.52XA, T26.60XA, T26.61XA, T26.62XA, T26.70XA, T26.71XA, T26.72XA, T26.80XA, T26.81XA, T26.82XA, T26.90XA, T26.91XA, T26.92XA H26.211, H26.212, H26.213, H26.219, H26.221, H26.222, H20.20, H20.21, H20.22, H20.23, H20.811, H20.812, H20.813, H20.819, H20.821, H20.822, H20.823, H20.829, H31.301, H31.302, H31.303, H31.309, H31.311, H31.312, H31.313, H31.319, H31.321, H31.322, H31.323, H31.329 H31.001, H31.002, H31.003, H31.009, H31.011, H31.012, H31.013, H31.019, H31.021, H31.022, H31.023, H31.029, A18.54, H20.10, H20.11, H20.12, H20.13, H20.9 H17.00, H17.01, H17.02, H17.03, H17.10, H17.11, H17.12, H17.13, H17.811, H17.812, H17.813, H17.819, H17.00, H17.01, H17.02, H17.03, H17.10, H17.11, H18.10, H18.11, H18.12, H18.13, H18.20, H18.221, H18.222, H18.223, H18.229, H18.231, H18.232, H18.233, H18.239, H18.421, H18.422, H18.423, H18.429, H18.43 H35.30, H35.31, H35.32, H35.341, H35.342, H35.343, H35.349, H35.351, H35.352, H35.353, H35.359, H35.361, H35.362, H35.363, H35.369, H35.371, H35.372, H35.373, H35.379, H35.381, H35.382, H35.383, H35.389 H44.20, H44.21, H44.22, H44.23, H44.321, H44.322, H44.323, H44.329, H44.311, H44.312, H44.313, H44.319, E08.311, E08.321, E08.331, E08.341, E08.351, E09.311, E09.321, E09.331, E09.341, E09.351, E10.311, E10.321, E10.331, E10.341, E10.351, E11.311, E11.321, E11.331, E11.341, E11.351, E13.311, E13.321, E13.331, E13.341, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
E08.311, E08.319, E08.321, E08.329, E08.331, E08.339, E08.341, E08.349, E08.351, E08.359, E09.311, E09.319, E09.321, E09.329, E09.331, E09.339, E09.341, E09.349, E09.351, E09.359, E10.311, E10.319, E10.321, E10.329, E10.331, E10.339, E10.341, E10.349, E10.351, E10.359, E11.311, E11.319, E11.321, E11.329, E11.331, E11.339, E11.341, E11.349, E11.351, E11.359, E13.311, E13.319, E13.321, E13.329, E13.331, E13.339, E13.341, E13.349, A18.53, H30.101, H30.102, H30.103, H30.109, H30.111, H30.112, H30.113, H30.119, H30.121, H30.122, H30.123, H30.129, H30.131, H30.132, H30.133, H30.139, H30.141, H30.001, H30.002, H30.003, H30.009, H30.011, H30.012, H30.013, H30.019, H30.021, H30.022, H30.023, H30.029, H30.031, H30.032, H30.033, H30.039, H30.041, H30.042, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.11X0, H40.11X1, H40.11X2, H40.11X3, H40.11X4, 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, H40.1290, H40.1291, H40.1292, H40.1293, H40.1294, H40.1310, H40.1311, H40.1312, H40.1313, H40.1314, H40.1320, H40.1321, H40.1322, H40.1323, H40.1324, H40.1330, H40.1331, H40.1332, H40.1333, H40.1334, H40.1390, H40.1391, H40.1392, H40.1393, H40.1394, H40.141, H40.142, H40.143, H40.149, H40.1510, H40.1511, H40.1512, H40.1513, H40.1514, H40.1520, H40.1521, H40.1522, H40.1523, H40.1524, H40.1530, H40.1531, H40.1532, H40.1533, H40.1534, H40.1590, H40.1591, H40.1592, H40.1593, H40.1594, H40.20X0, H40.20X1, H40.20X2, H40.20X3, H40.20X4, H40.211, H40.212, H40.213, H40.219, H40.2210, H40.2211, H40.2212, H40.2213, H40.2214, H40.2220, H40.2221, H40.2222, H40.2223, H40.2224, H40.2230, H40.2231, H40.2232, H40.2233, H40.2234, H40.2290, H40.2291, H40.2292, H40.2293, H40.2294, H40.231, H40.232, H40.233, H40.239, H40.241, H40.242, H40.243, H40.249, H40.30X0, H40.30X1, H40.30X2, H40.30X3, H40.30X4, H40.31X0, H40.31X1, H40.31X2, H40.31X3, H40.31X4, H40.32X0, H40.32X1, H40.32X2, H40.32X3, H40.32X4, H40.33X0, H40.33X1, H40.33X2, H40.33X3, H40.33X4, H40.40X0, H40.40X1, H40.40X2, H40.40X3, H40.40X4, H40.41X0, H40.41X1, H40.41X2, H40.41X3, H40.41X4, H40.42X0, H40.42X1, H40.42X2, H40.42X3, H40.42X4, H40.43X0, H40.43X1, H40.43X2, H40.43X3, H40.43X4, H40.50X0, H40.50X1, H40.50X2, H40.50X3, H40.50X4, H40.51X0, H40.51X1, H40.51X2, H40.51X3, H40.51X4, H40.52X0, H40.52X1, H40.52X2, H40.52X3, H40.52X4, H40.53X0, H40.53X1, H40.53X2, H40.53X3, H40.53X4, H40.60X0, H40.60X1, H40.60X2, H40.60X3, H40.60X4, H40.61X0, H40.61X1, H40.61X2, H40.61X3, H40.61X4, H40.62X0, H40.62X1, H40.62X2, H40.62X3, H40.62X4, H40.63X0, H40.63X1, H40.63X2, H40.63X3, H40.63X4, H40.811, H40.812, H40.813, H40.819, H40.821, H40.822, H40.823, H40.829, H40.831, H40.832, H40.833, H40.839, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H40.30X0, H40.30X1, H40.30X2, H40.30X3, H40.30X4, H40.31X0, H40.31X1, H40.31X2, H40.31X3, H40.31X4, H40.32X0, H40.32X1, H40.32X2, H40.32X3, H40.32X4, H40.33X0, H40.33X1, H40.33X2, H40.33X3, H40.33X4, H40.40X0, H40.40X1, H40.40X2, H40.40X3, H40.40X4, H40.41X0, H40.41X1, H40.41X2, H40.41X3, H40.41X4, H40.42X0, H40.42X1, H40.42X2, H40.42X3, H40.42X4, H40.43X0, H40.43X1, H40.43X2, H40.43X3, H40.43X4, H40.50X0, H40.50X1, H40.50X2, H40.50X3, H40.50X4, H40.51X0, H40.51X1, H40.51X2, H40.51X3, H40.51X4, H40.52X0, H40.52X1, H40.52X2, H40.52X3, H40.52X4, H40.53X0, H40.53X1, H40.53X2, H40.53X3, H40.53X4, H40.811, H40.812, H40.813, H40.819, H40.821, H40.822, H40.823, H40.829, H40.831, H40.832, H40.833, H40.839, H18.50, H18.51, H18.52, H18.53, H18.54, H18.55, H35.50, H35.51, H35.52, H35.53, H35.54, H36 Injury to Optic Nerve and Pathways S04.011A, S04.012A, S04.019A, S04.02XA, S04.031A, S04.032A, S04.039A, S04.041A, S04.042A, S04.049A Lesser Eye Nystagmus and Other Irregular Eye H55.01 S05.10XA, S05.11XA, S05.12XA, S05.20XA, S05.21XA, S05.22XA, S05.30XA, S05.31XA, S05.32XA, S05.50XA, S05.51XA, S05.52XA, S05.60XA, S05.61XA, S05.62XA, S05.70XA, S05.71XA, S05.72XA, S05.8X1A, S05.8X2A, H47.20, H47.211, H47.212, H47.213, H47.219, H47.22, H47.231, H47.232, H47.233, H47.239, H47.291, H47.292, H46.00, H46.01, H46.02, H46.03, H46.10, H46.11, H46.12, H46.13, H46.2, H46.3, H46.8, H46.9 Other Background Retinopathy and H35.021, H35.022, H35.023, H35.029, H35.051, H35.052, H35.053, H35.059, H35.061, H35.062, H35.063, H35.069 H18.70, H18.711, H18.712, H18.713, H18.719, H18.721, H18.722, H18.723, H18.729, H18.731, H18.732, H18.733, H18.739, H18.791, H18.792, H18.793, H18.799 H15.831, H15.832, H15.833, H15.839, H15.841, H15.842, H16.241, H16.242, H16.243, H16.249, H21.331, H21.332, H21.333, H21.339, H33.121, H33.122, H33.123, H33.129, H44.111, H44.112, H44.113, H44.119, H44.121, H44.122, H44.123, H44.129, H44.131, H44.132, H44.133, H44.139, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H35.101, H35.102, H35.103, H35.109, H35.111, H35.112, H35.113, H35.119, H35.121, H35.122, H35.123, H35.129, H35.131, H35.132, H35.133, H35.139, H35.141, H35.142, H35.143, H35.149, H35.151, H35.152, H35.153, H35.159, H35.161, H35.162, H35.163, H35.169, H35.171, H35.172, H35.60, H35.61, H35.62, H35.63, H35.81, H35.89, H30.20, H30.21, H30.22, H30.23, H30.811, H30.812, Chorioretinitis and Retinochoroiditis H30.813, H30.819, H30.891, H30.892, H30.893, H30.899, H18.601, H18.602, H18.603, H18.609, H18.611, H18.612, H18.613, H18.619, H18.621, H18.622, H18.623, H18.629 H44.001, H44.002, H44.003, H44.009, H44.011, H44.012, H44.013, H44.019, H44.021, H44.022, H44.023, H44.029, H33.001, H33.002, H33.003, H33.009, H33.011, H33.012, H33.013, H33.019, H33.021, H33.022, H33.023, H33.029, H33.031, H33.032, H33.033, H33.039, H33.041, H33.042, H33.043, H33.049, H33.051, H33.052, H33.053, H33.059, H34.10, H34.11, H34.12, H34.13, H34.231, H34.232, H34.233, H34.239, H34.811, H34.812, H34.813, H34.819, A18.51, H15.021, H15.022, H15.023, H15.029, H15.031, H15.032, H15.033, H15.039, H15.041, H15.042, H15.043, H15.049, H15.051, H15.052, H15.053, H15.059, H15.091, H35.711, H35.712, H35.713, H35.719, H35.721, H35.722, H35.723, H35.729, H35.731, H35.732, H35.733, H35.739 H44.111, H44.112, H44.113, H44.119, H44.131, H44.132,
NUMERATOR:
P atients who had best-corrected visual acuity of 20/40 or bet er (distance or near) achieved within 90 days Numerator Options:
Best-corrected visual acuity of 20/40 or bet er (distance or near) achieved within 90 days fol owing cataract surgery (4175F)
Best-corrected visual acuity of 20/40 or bet er (distance or near) not achieved within 90 days
fol owing cataract surgery, reason not otherwise specified (4175F with 8P)
NOTE: The detailed instructions in this specification apply exclusively to the reporting and analysis of the included measures under the measures groups option. For al other claims-based or registry-based reporting options, please see the measures’ ful specifications in the document “2013 P hysician Quality Reporting System (P QRS) Measure Specifications Manual for Claims and Registry Reporting for Individual Measures” available for download from the CMS P QRS website Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Measure #192 (NQF 0564): Cataracts: Complications within 30 Days Fol owing Cataract Surgery
Requiring Additional Surgical Procedures

DESCRIPTION:

P ercentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and had any of a specified list of surgical procedures in the 30 days fol owing cataract surgery which would indicate the occurrence of any of the fol owing major complications: retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence
Note: This is an outcomes measure and can be calculated solely using registry data.
� For patients who receive the cataract surgical procedures specified in the denominator coding, claims should be reviewed to determine if any of the procedure codes listed in the numerator were performed within 30 days of the date of cataract surgery. � Patients who have any of the listed comorbid conditions in the exclusion criteria should be removed from the denominator, and not considered as having a complication within 30 days fol owing (P atients with documentation of one or more of the fol owing comorbid conditions prior to date of cataract surgery are excluded from the measure calculation) Comorbid Condition
Corresponding ICD-9-CM Codes
364.00, 364.01, 364.02, 364.03, 364.04, 364.05 364.70, 364.71, 364.72, 364.73, 364.74, 364.75, 940.0, 940.1, 940.2, 940.3, 940.4, 940.5, 940.9 371.20, 371.21, 371.22, 371.23, 371.43, 371.44 Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-9-CM Codes
365.10, 365.11, 365.12, 365.13, 365.14, 365.15, 365.20, 365.21, 365.22, 365.23, 365.24, 365.31, 365.32, 365.51, 365.52, 365.59, 365.60, 365.61, 365.62, 365.63, 365.64, 365.65, 365.81, 365.82, 371.50, 371.51, 371.52, 371.53, 371.54, 371.55, Injury to Optic Nerve and Pathways 950.0, 950.1, 950.2, 950.3, 950.9 Open Wound of Eyebal 871.0, 871.1, 871.2, 871.3, 871.4, 871.5, 871.6, 871.7, 67036, 67039, 67040, 67041, 67042, 67043 (patient P atient taking tamsulosin hydrochloride Treatment of P rostatic Hypertrophy Uveitis Comorbid Condition
Corresponding ICD-10-CM Codes
H20.00, H20.011, H20.012, H20.013, H20.019, H20.021, H20.022, H20.023, H20.029, H20.031, H20.032, H20.033, H20.039, H20.041, H20.042, H20.043, H20.049, H20.051, H20.052, H20.053, H21.40, H21.41, H21.42, H21.43, H21.501, H21.502, H21.503, H21.509, H21.511, H21.512, H21.513, H21.519, H21.521, H21.522, H21.523, H21.529, H21.531, H21.532, H21.533, H21.539, H21.541, H21.542, H21.543, H21.549, H21.551, H21.552, H21.553, H21.559, H21.561, H21.562, H21.563, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H27.10, H27.111, H27.112, H27.113, H27.119, H27.121, H27.122, H27.123, H27.129, H27.131, T26.00XA, T26.01XA, T26.02XA, T26.10XA, T26.11XA, T26.12XA, T26.20XA, T26.21XA, T26.22XA, T26.30XA, T26.31XA, T26.32XA, T26.40XA, T26.41XA, T26.42XA, T26.50XA, T26.51XA, T26.52XA, T26.60XA, T26.61XA, T26.62XA, T26.70XA, T26.71XA, T26.72XA, T26.80XA, T26.81XA, T26.82XA, T26.90XA, T26.91XA, T26.92XA H26.211, H26.212, H26.213, H26.219, H26.221, H20.20, H20.21, H20.22, H20.23, H20.811, H20.812, H20.813, H20.819, H20.821, H20.822, H20.823, A18.54, H20.10, H20.11, H20.12, H20.13, H20.9 H17.00, H17.01, H17.02, H17.03, H17.10, H17.11, H17.12, H17.13, H17.811, H17.812, H17.813, H17.819, H17.00, H17.01, H17.02, H17.03, H17.10, H17.11, H18.10, H18.11, H18.12, H18.13, H18.20, H18.221, H18.222, H18.223, H18.229, H18.231, H18.232, H18.233, H18.239, H18.421, H18.422, H18.423, H21.301, H21.302, H21.303, H21.309, H21.311, H21.312, H21.313, H21.319, H21.321, H21.322, H21.323, H21.329, H21.341, H21.342, H21.343, H21.349, H21.351, H21.352, H21.353, H21.359 H05.401, H05.402, H05.403, H05.409, H05.411, H05.412, H05.413, H05.419, H05.421, H05.422, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
H40.10X0, H40.10X1, H40.10X2, H40.10X3, H40.10X4, H40.11X0, H40.11X1, H40.11X2, H40.11X3, H40.11X4, 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, H40.1290, H40.1291, H40.1292, H40.1293, H40.1294, H40.1310, H40.1311, H40.1312, H40.1313, H40.1314, H40.1320, H40.1321, H40.1322, H40.1323, H40.1324, H40.1330, H40.1331, H40.1332, H40.1333, H40.1334, H40.1390, H40.1391, H40.1392, H40.1393, H40.1394, H40.141, H40.142, H40.143, H40.149, H40.1510, H40.1511, H40.1512, H40.1513, H40.1514, H40.1520, H40.1521, H40.1522, H40.1523, H40.1524, H40.1530, H40.1531, H40.1532, H40.1533, H40.1534, H40.1590, H40.1591, H40.1592, H40.1593, H40.1594, H40.20X0, H40.20X1, H40.20X2, H40.20X3, H40.20X4, H40.211, H40.212, H40.213, H40.219, H40.2210, H40.2211, H40.2212, H40.2213, H40.2214, H40.2220, H40.2221, H40.2222, H40.2223, H40.2224, H40.2230, H40.2231, H40.2232, H40.2233, H40.2234, H40.2290, H40.2291, H40.2292, H40.2293, H40.2294, H40.231, H40.232, H40.233, H40.239, H40.241, H40.242, H40.243, H40.249, H40.30X0, H40.30X1, H40.30X2, H40.30X3, H40.30X4, H40.31X0, H40.31X1, H40.31X2, H40.31X3, H40.31X4, H40.32X0, H40.32X1, H40.32X2, H40.32X3, H40.32X4, H40.33X0, H40.33X1, H40.33X2, H40.33X3, H40.33X4, H40.40X0, H40.40X1, H40.40X2, H40.40X3, H40.40X4, H40.41X0, H40.41X1, H40.41X2, H40.41X3, H40.41X4, H40.42X0, H40.42X1, H40.42X2, H40.42X3, H40.42X4, H40.43X0, H40.43X1, H40.43X2, H40.43X3, H40.43X4, H40.50X0, H40.50X1, H40.50X2, H40.50X3, H40.50X4, H40.51X0, H40.51X1, H40.51X2, H40.51X3, H40.51X4, H40.52X0, H40.52X1, H40.52X2, H40.52X3, H40.52X4, H40.53X0, H40.53X1, H40.53X2, H40.53X3, H40.53X4, H40.60X0, H40.60X1, H40.60X2, H40.60X3, H40.60X4, H40.61X0, H40.61X1, H40.61X2, H40.61X3, H40.61X4, H40.62X0, H40.62X1, H40.62X2, H40.62X3, H40.62X4, H40.63X0, H40.63X1, H40.63X2, H40.63X3, H40.63X4, H40.811, H40.812, H40.813, H40.819, H40.821, H40.822, H40.823, H40.829, H40.831, H40.832, H40.833, H40.839, H40.89, Q15.0 H18.50, H18.51, H18.52, H18.53, H18.54, H18.55, H44.40, H44.411, H44.412, H44.413, H44.419, H44.421, H44.422, H44.423, H44.429, H44.431, H44.432, H44.433, H44.439, H44.441, H44.442, Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Comorbid Condition
Corresponding ICD-10-CM Codes
Injury to Optic Nerve and Pathways S04.011A, S04.012A, S04.019A, S04.02XA, S04.031A, S04.032A, S04.039A, S04.041A, S04.042A, S04.049A 67036, 67039, 67040, 67041, 67042, 67043 (patient H26.101, H26.102, H26.103, H26.109, H26.111, H26.112, H26.113, H26.119, H26.121, H26.122, H26.123, H26.129, H26.131, H26.132, H26.133, P atient taking tamsulosin hydrochloride Treatment of P rostatic Hypertrophy Uveitis H44.111, H44.112, H44.113, H44.119, H44.131,
NUMERATOR:

P atients who had one or more specified operative procedures for any of the fol owing major complications within 30 days fol owing cataract surgery: retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence Numerator Instructions: Codes for major complications (e.g., retained nuclear fragments,
endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence): 65235, 65800, 65810, 65815, 65860, 65880, 65900, 65920, 65930, 66030, 66250, 66820, 66825, 66830, 66852, 66986, 67005, 67010, 67015, 67025, 67028, 67030, 67031, 67036, 67039, 67041, 67042, 67043, 67101, 67105, 67107, 67108, 67110, 67112, 67141, 67145, 67250, 67255
NUMERATOR NOTE:
For performance, a lower rate indicates bet er performance.

Numerator Options:

Surgical procedure performed within 30 days fol owing cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment or wound dehiscence) (G8627)
Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Surgical procedure not performed within 30 days fol owing cataract surgery for major complications
(e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment or wound dehiscence) (G8628)


.



NOTE: The detailed instructions in this specification apply exclusively to the reporting and analysis of the included measures under the measures

groups option. For al other claims-based or registry-based reporting options, please see the measures’ ful specifications in the document “2013 P hysician Quality Reporting System (P QRS) Measure Specifications Manual for Claims and Registry Reporting for Individual Measures” available for download from the CMS P QRS website. Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Measure #303: Cataracts: Improvement in Patient’s Visual Function within 90 Days Fol owing
Cataract Surgery

DESCRIPTION:

P ercentage of patients aged 18 years and older in sample who had cataract surgery and had improvement in visual function achieved within 90 days fol owing the cataract surgery, based on completing a pre- operative and post-operative visual function survey
Note: This is an outcomes measure and wil be calculated solely using registry data.
� For patients who receive the cataract surgical procedures specified in the denominator coding in the sample, it should be reported whether or not the patient had improvement in visual function achieved within 90 days fol owing the cataract surgery. � Include only procedures performed through September 30 of the reporting period. This
wil al ow the post operative period to occur before registries must submit data to CMS. � It is the responsibility of a third party, which may be the registry or another third party designated by the eligible professional to administer, receive results, and review the surveys. Each registry must work directly with eligible professionals who wish to report these measures to determine who (a registry or another third party) wil be administering, receiving and reviewing the surveys. NUMERATOR:
P atients 18 years and older who had improvement in visual function achieved within 90 days fol owing cataract surgery, based on completing a pre-operative and post-operative visual function survey Numerator Options:
Improvement in visual function achieved within 90 days fol owing cataract surgery (G0913)
P atient care survey was not completed by patient (G0914)
Improvement in visual function not achieved within 90 days fol owing cataract surgery (G0915)
NOTE: The detailed instructions in this specification apply exclusively to the reporting and analysis of the included measures under the measures groups option. For al other claims-based or registry-based reporting options, please see the measures’ ful specifications in the document “2013 P hysician Quality Reporting System (P QRS) Measure Specifications Manual for Claims and Registry Reporting for Individual Measures” available for download from the CMS P QRS website. Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012 SPECIFICATION FOR MEASURES GROUP REPORTING ONLY
Measure #304: Cataracts: Patient Satisfaction within 90 Days Fol owing Cataract Surgery

DESCRIPTION:

P ercentage of patients aged 18 years and older in sample who had cataract surgery and were satisfied with their care within 90 days fol owing the cataract surgery, based on completion of the Consumer Assessment of Healthcare P roviders and Systems Surgical Care Survey
Note: This is an outcomes measure and wil be calculated solely using registry data.
� For patients who receive the cataract surgical procedures specified in the denominator coding in the sample, it should be reported whether or not the patient was satisfied with their care within 90 days fol owing the cataract surgery. � Include only procedures performed through September 30 of the reporting period. This
wil al ow the post operative period to occur before registries must submit data to CMS. � It is the responsibility of a third party, which may be the registry or another third party designated by the eligible professional to administer, receive results, and review the surveys. Each registry must work directly with eligible professionals who wish to report these measures to determine who (a registry or another third party) wil be administering, receiving and reviewing the surveys. NUMERATOR:
P atients 18 years and older in the sample who were satisfied with their care within 90 days fol owing cataract surgery, based on completion of the Consumer Assessment of Healthcare P roviders and Systems Numerator Options:
Satisfaction with care achieved within 90 days fol owing cataract surgery (G0916)
P atient care survey was not completed by patient (G0917)
Satisfaction with care not achieved within 90 days fol owing cataract surgery (G0918)
NOTE: The detailed instructions in this specification apply exclusively to the reporting and analysis of the included measures under the measures groups option. For al other claims-based or registry-based reporting options, please see the measures’ ful specifications in the document “2013 P hysician Quality Reporting System (P QRS) Measure Specifications Manual for Claims and Registry Reporting for Individual Measures” available for download from the CMS P QRS website. Version 6.1 CP T only copyright 2012 American Medical Association. Al rights reserved. 12/19/2012

Source: http://www.mdinteractive.co/files/uploaded/file/cms2013group/Cataracts_2013_CMS.pdf

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RECOMMENDED DRUG LIST ALPHABETICAL TIER GENERIC DRUG NAME SUGGESTED ALTERNATIVE DRUGS / MESSAGES A/T/S SOLUTION (SWABS, PADS & PLEDGETS EXCLUDED)TRIAL OF SINGULAIR (PA for 10 MG STRENGTH) REQUIREDACCU-CHEK COMPACT PLUS TEST STRIPS / DRUM (QL)Lisinopril (ZESTRIL), Benazepril (LOTENSIN), Captopril (CAPOTEN), Fosinopril Acetaminophen 2.5 / Hydrocodone 1.67 ElixirAcetaminoph

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Environment and Crime in the Inner City: Does Vegetation Reduce Crime? Environment and Behavior 2001; 33; 343 The online version of this article can be found at:http://eab.sagepub.com/cgi/content/abstract/33/3/343Environmental Design Research Association can be found at: Environment and Behavior Additional services and information for Email Alerts: http://eab.sagepub.com/c

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