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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
140 0566 Process Yes Effective Clinical Care
Claims

Measure Description

Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD

Instructions

This measure is to be submitted a minimum of once per performance period for AMD patients seen during the performance period. It is anticipated that eligible clinicians who provide the primary management of patients with AMD will submit this measure.

NOTE: No notes for this Quality ID

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator quality-data codes included in this specification are used to submit the quality actions allowed by the measure. All measure-specific coding should be submitted on the claim(s) representing the eligible encounter.

Numerator

Patients with AMD or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the AREDS 2 formulation for preventing progression of AMD

Numerator Instructions:

Data not available

Numerator Quality-Data Coding Options

Numerator Note:

If patient is already receiving AREDS 2 formulation, the assumption is that counseling about AREDS has already been performed.

Denominator

All patients aged 50 years and older with a diagnosis of AMD

Eligible cases are determined and must be reported, if either of the following conditions:

Option 1 – Denominator Criteria (Eligible Cases):

Patients aged ≥ 50 years on date of encounter

AND

Diagnosis for AMD (ICD-10-CM):H35.30, H35.3110, H35.3111, H35.3112, H35.3113, H35.3114, H35.3120, H35.3121, H35.3122, H35.3123, H35.3124, H35.3130, H35.3131, H35.3132, H35.3133, H35.3134, H35.3210, H35.3211, H35.3212, H35.3213, H35.3220, H35.3221, H35.3222, H35.3223, H35.3230, H35.3231, H35.3232, H35.3233

AND

Patient encounter during the performance period (CPT): 92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99242*, 99243*, 99244*, 99245*, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

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