Cataracts2040BCVAwithin90DaysFHIR
type: Measure
node role: treeRoot
id:
  v: Cataracts2040BCVAwithin90DaysFHIR
meta:
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm
    l: computable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm
    l: publishable-measure-cqfm
  profile:
    v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm
    l: executable-measure-cqfm
text:
  status:
    v: extensions
  div:
    v: Title: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract SurgeryFHIR Id: Cataracts2040BCVAwithin90DaysFHIR Download cql: Cataracts2040BCVAwithin90DaysFHIR.cql Version: 0.0.007 Url: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract SurgeryFHIR short-name identifier: CMS133FHIR version-independent identifier: urn:uuid:84905817-706b-48a8-a8f8-a05436cd6a0e version-specific identifier: urn:uuid:71bb8dc6-ca81-48a4-aa82-af4a0df0e92c endorser (NQF) identifier: 0565e publisher (CMS) identifier: 133FHIR Effective Period: 2024-01-01 ..2024-12-31 Status: draft Date: 2023-10-27 08:12:31+0000 Approval Date: 2023-08-14 Last Review Date: 2023-08-14 Name: Cataracts2040BCVAwithin90DaysFHIR Publisher: American Academy of Ophthalmology Author: American Academy of Ophthalmology: www.aao.org, American Medical Association (AMA): https://www.ama-assn.org/ Description: Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye within 90 days following the cataract surgery Use Context: code value program Purpose: UNKNOWN Copyright: Copyright 2023 American Academy of Ophthalmology. All Rights Reserved. Disclaimer: The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measure require a license agreement between…
contained: Library
  id:
    v: effective-data-requirements
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://hl7.org/fhir/v3/AdministrativeGender
        l: AdministrativeGender
      code:
        v: M
      display:
        v: Male
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://hl7.org/fhir/v3/AdministrativeGender
        l: AdministrativeGender
      code:
        v: F
      display:
        v: Female
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      type: http://snomed.info/id/419775003
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 419775003
      display:
        v: Best corrected visual acuity (observable entity)
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: active
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: recurrence
  extension:
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode
      l: cqfm-directReferenceCode
    value: Coding
      system:
        v: http://terminology.hl7.org/CodeSystem/condition-clinical
        l: condition-clinical
      code:
        v: relapse
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: SupplementalDataElements
    extension:
      url:
        v: name
        l: name
      value: String
        v: SDE Sex
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "SDE Sex": case when Patient.gender = 'male' then "M" when Patient.gender = 'female' then "F" else null end
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 0
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: Cataracts2040BCVAwithin90DaysFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: SDE Sex
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "SDE Sex": SDE."SDE Sex"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 1
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: Cataracts2040BCVAwithin90DaysFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: Cataract Surgery Between January and September of Measurement Period
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Cataract Surgery Between January and September of Measurement Period": [Procedure: "Cataract Surgery"] CataractSurgery where CataractSurgery.performed.toInterval ( ) during "Measurement Period" and CataractSurgery.performed.toInterval ( ) starts 92 days or more before end of "Measurement Period" and CataractSurgery.status = 'completed'
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 2
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: Cataracts2040BCVAwithin90DaysFHIR
    extension:
      url:
        v: name
        l: name
      value: String
        v: Numerator
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Numerator": "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed with ( [Observation: "Best corrected visual acuity (observable entity)"] union [Observation: "Best Corrected Visual Acuity Exam Using Snellen Chart"] ) VisualAcuityExamPerformed such that VisualAcuityExamPerformed.effective.toInterval ( ) 90 days or less after day of end of CataractSurgeryPerformed.performed.toInterval ( ) and VisualAcuityExamPerformed.status in { 'final', 'amended', 'corrected', 'preliminary' } and VisualAcuityExamPerformed.value as Concept in "Visual Acuity 20/40 or Better"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 3
    url:
      v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
      l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Initial Population
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Initial Population": "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed where AgeInYearsAt(date from start of "Measurement Period") >= 18
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator": "Initial Population"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": [Coverage: type in "Payer Type"] Payer return { code: Payer.type, period: Payer.period }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Payer
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Payer": SDE."SDE Payer"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": Patient.ethnicity E return Tuple { codes: { E.ombCategory } union E.detailed, display: E.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Ethnicity
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Ethnicity": SDE."SDE Ethnicity"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: Denominator Exclusions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Denominator Exclusions": "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed with ( [Condition: "Acute and Subacute Iridocyclitis"] union [Condition: "Amblyopia"] union [Condition: "Burn Confined to Eye and Adnexa"] union [Condition: "Cataract Secondary to Ocular Disorders"] union [Condition: "Cataract Congenital"] union [Condition: "Cataract Mature or Hypermature"] union [Condition: "Cataract Posterior Polar"] union [Condition: "Central Corneal Ulcer"] union [Condition: "Certain Types of Iridocyclitis"] union [Condition: "Choroidal Degenerations"] union [Condition: "Choroidal Detachment"] union [Condition: "Choroidal Hemorrhage and Rupture"] union [Condition: "Chronic Iridocyclitis"] union [Condition: "Cloudy Cornea"] union [Condition: "Corneal Edema"] union [Condition: "Disorders of Cornea Including Corneal Opacity"] union [Condition: "Degeneration of Macula and Posterior Pole"] union [Condition: "Degenerative Disorders of Globe"] union [Condition: "Diabetic Macular Edema"] union [Condition: "Diabetic Retinopathy"] union [Condition: "Disorders of Optic Chiasm"] union [Condition: "Disorders of Visual Cortex"] union [Condition: "Disseminated Chorioretinitis and Disseminated Retinochoroiditis"] union [Condition: "Focal Chorioretinitis and Focal Retinochoroiditis"] union [Condition: "Glaucoma"] union [Condition: "Glaucoma Associated with Congenital Anomalies and Dystrophies and Systemic Syndromes"] union [Condition: "Hereditary Choroidal Dystrophies"] union [Condition: "Hereditary Corneal Dystrophies"] union [Condition: "Hereditary Retinal Dystrophies"] union [Condition: "Hypotony of Eye"] union [Condition: "Injury to Optic Nerve and Pathways"] union [Condition: "Macular Scar of Posterior Polar"] union [Condition: "Morgagnian Cataract"] union [Condition: "Nystagmus and Other Irregular Eye Movements"] union [Condition: "Open Wound of Eyeball"] union [Condition: "Optic Atrophy"] union [Condition: "Optic Neuritis"] unio…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: SupplementalDataElements
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": Patient.race R return Tuple { codes: R.ombCategory union R.detailed, display: R.text }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: Cataracts2040BCVAwithin90DaysFHIR
extension:
  url:
    v: name
    l: name
  value: String
    v: SDE Race
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "SDE Race": SDE."SDE Race"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: toInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in QICore, allowing this function to be used across any resource. The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>. The intent of this function is to provide a clear and concise mechanism to treat single elements that have multiple possible representations as intervals so that logic doesn't have to account for the variability. More complex calculations (such as medication request period or dispense period calculation) need specific guidance and consideration. That guidance may make use of this function, but the focus of this function is on single element calculations where the semantics are unambiguous. If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime. If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age, and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later. If the input is a DateTime Interval, the result is the input. If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending immediately before one year later than the date the patient turned the age given as the end of the quantity interval. Any other input will reslt in a null DateTime Interval */ define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>>): case when choice is DateTim…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value uri): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: prevalenceInterval
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* @description: Returns an interval representing the normalized prevalence period of a given Condition. @comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from onset to abatement as specified in the given Condition. If the condition is active, the resulting interval will have a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary. */ define fluent function prevalenceInterval(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()] else Interval[start of condition.onset.toInterval(), end of condition.abatementInterval())
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: QICoreCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: isActive
extension:
  url:
    v: statement
    l: statement
  value: String
    v: /* Candidates for FHIRCommon */ /* @description: Returns true if the given condition has a clinical status of active, recurrence, or relapse */ define fluent function isActive(condition Condition): condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition
  l: cqfm-logicDefinition

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: Library SDE
resource:
  v: http://ecqi.healthit.gov/ecqms/Library/SupplementalDataElements|3.4.000
  l: http://ecqi.healthit.gov/ecqms/Library/SupplementalDataElements

type:
  v: depends-on
display:
  v: Library QICoreCommon
resource:
  v: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon|1.5.000
  l: http://ecqi.healthit.gov/ecqms/Library/QICoreCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers|4.3.000
  l: http://ecqi.healthit.gov/ecqms/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Code system AdministrativeGender
resource:
  v: http://hl7.org/fhir/v3/AdministrativeGender
  l: AdministrativeGender

type:
  v: depends-on
display:
  v: Code system SNOMEDCT
resource:
  v: http://snomed.info/sct
  l: sct

type:
  v: depends-on
display:
  v: Code system ConditionClinicalStatusCodes
resource:
  v: http://terminology.hl7.org/CodeSystem/condition-clinical
  l: condition-clinical

type:
  v: depends-on
display:
  v: Value set Cataract Surgery
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1411
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1411

type:
  v: depends-on
display:
  v: Value set Best Corrected Visual Acuity Exam Using Snellen Chart
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1560
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1560

type:
  v: depends-on
display:
  v: Value set Visual Acuity 20/40 or Better
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1483
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1483

type:
  v: depends-on
display:
  v: Value set Payer Type
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

type:
  v: depends-on
display:
  v: Value set Acute and Subacute Iridocyclitis
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1241
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1241

type:
  v: depends-on
display:
  v: Value set Amblyopia
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1448
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1448

type:
  v: depends-on
display:
  v: Value set Burn Confined to Eye and Adnexa
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1409
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1409

type:
  v: depends-on
display:
  v: Value set Cataract Secondary to Ocular Disorders
resource:
  v: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1410
  l: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1410

type:
  v: depends-on
display:
  v: Value set Cataract Congenital
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v: 0.0.007

v: Cataracts2040BCVAwithin90DaysFHIR

v: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract SurgeryFHIR

v: draft

v: false

v: 2023-10-27T08:12:31+00:00

v: American Academy of Ophthalmology

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v: Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye within 90 days following the cataract surgery

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v: UNKNOWN

v: This eCQM is an episode-based measure. An episode for this measure is defined as each cataract surgery during the measurement period, including instances where more than one cataract procedure was performed during the measurement period. Every cataract surgery during the measurement period should be counted as a measurable denominator event for the measure calculation. Only procedures performed during January 1 - September 30 of the reporting period will be considered for this measure, in order to determine if 20/40 or better visual acuity has been achieved within the 90 days following the cataract procedure. Cataract procedures performed during October 1 - December 31 are excluded from the initial population. The measure, as written, does not specifically require documentation of laterality. Coding limitations in particular clinical terminologies do not currently allow for that level of specificity (ICD-10-CM includes laterality, but SNOMED-CT does not uniformly include this distinction). Therefore, at this time, it is not a requirement of this measure to indicate laterality of the diagnoses, findings or procedures. Available coding to capture the data elements specified in this measure has been provided. It is assumed that the eligible professional or eligible clinician will record laterality in the patient medical record, as quality care and clinical documentation should include laterality. This measure is to be reported by the clinician performing the cataract surgery procedure. Clinicians who provide only preoperative or postoperative management of cataract patients are not eligible for this measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible encounter codes. This FHIR-based measure has been derived from the QDM-based measure: CMS133v12. Please refer to the HL7 QI-Core Implementation Guide (http://hl7.org/fhir/us/qicore/index.html) for more information on QI-Core and mapping recommendations f…

v: Copyright 2023 American Academy of Ophthalmology. All Rights Reserved.

v: 2023-08-14

v: 2023-08-14

start:
  v: 2024-01-01
end:
  v: 2024-12-31

name:
  v: American Academy of Ophthalmology
telecom:
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    v: url
  value:
    v: www.aao.org

name:
  v: American Medical Association (AMA)
telecom:
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    v: url
  value:
    v: https://www.ama-assn.org/

v: The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measure require a license agreement between the user and the American Academy of Ophthalmology (Academy). Neither the Academy, PCPI, nor the American Medical Association (AMA), nor the former AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), nor their members shall be responsible for any use of the Measure. The PCPI’s and AMA’s significant past efforts and contributions to the development and updating of the Measures are acknowledged. The National Committee for Quality Assurance’s significant past efforts and contributions to the development and updating of the Measure is acknowledged. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Limited proprietary coding is contained in the Measure specifications for convenience. A license agreement must be entered prior to a third party’s use of Current Procedural Terminology (CPT[R]) or other proprietary code set contained in the Measures. Any other use of CPT or other coding by the third party is strictly prohibited. The Academy, its members, the AMA, and former members of the PCPI disclaim all liability for use or accuracy of any CPT or other coding contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) co…

v: In the United States, cataracts affect more than 24 million adults over 40 years (National Eye Institute, 2019). According to the American Academy of Ophthalmology (2021), cataract surgery has a substantial beneficial impact on visual function and on quality of life. 1. Scientific basis for measuring visual acuity outcomes after cataract surgery The only reason to perform cataract surgery (other than for a limited set of medical indications) is to improve a patient's vision and associated functioning. The use of a 20/40 visual acuity threshold is based on several considerations. First, it is the level for unrestricted operation of a motor vehicle in the US. Second, it has been consistently used by the FDA in its assessment for approval of intraocular lens (IOL) and other vision devices. Third, it is the literature standard to denote success in cataract surgery. Fourth, work by West et al. in the Salisbury Eye Study suggests that 20/40 is a useful threshold for 50th percentile functioning for several vision-related tasks. Most patients achieve excellent visual acuity after cataract surgery (20/40 or better). This outcome is achieved consistently through careful attention through the accurate measurement of axial length and corneal power and the appropriate selection of an IOL power calculation formula. As such, it reflects the care and diligence with which the surgery is assessed, planned and executed. Failure to achieve this after surgery in eyes without comorbid ocular conditions that would impact the success of the surgery would reflect care that should be assessed for opportunities for improvement. The exclusion of patients with other ocular and systemic conditions known to increase the risk of an adverse outcome reflects the findings of the two published prediction rule papers for cataract surgery outcomes, by Mangione et al. (1995) and Steinberg et al. (1994). In both papers, the presence of comorbid glaucoma and macular degeneration negatively impacted the lik…

v: This is an outcome measure. As such, there is no statement in the guideline specific to this measurement topic.

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