Diabetes: Eye Exam (NQF 0055)
-
Initial Patient Population =
- AND: "Patient Characteristic: birth date" >= 17 year(s) starts before start of "Measurement period"
- AND: "Patient Characteristic: birth date" <= 74 year(s) starts before start of "Measurement period"
-
Denominator =
- AND: "Initial Patient Population"
- AND:
- OR:
- AND: "Diagnosis, Active: diabetes"
- AND:
- OR: "Encounter: Encounter acute inpatient or ED"
- OR:
- AND: Count >= 2 of:"Encounter: Encounter non-acute inpatient and outpatient"
- AND: FIRST:"Encounter: Encounter non-acute inpatient and outpatient" starts before start of SECOND :"Encounter: Encounter
non-acute inpatient and outpatient"
- OR: "Medication, Dispensed: Medications indicative of diabetes"
- <= 2 year(s) starts before or during "Measurement end date"
-
Denominator Exclusions =
- AND:
- OR:
- AND:
- AND NOT: "Diagnosis, Active: diabetes"
- AND NOT:
- OR: "Encounter: Encounter acute inpatient or ED"
- OR: "Encounter: Encounter non-acute inpatient and outpatient"
- <= 2 year(s) starts before or during "Measurement end date"
- AND: "Diagnosis, Active: polycystic ovaries" starts before or during "Measurement end date"
- OR:
- AND:
- AND NOT: "Diagnosis, Active: diabetes"
- AND NOT:
- OR: "Encounter: Encounter acute inpatient or ED"
- OR: "Encounter: Encounter non-acute inpatient and outpatient"
- AND:
- OR: "Diagnosis, Active: gestational diabetes"
- OR: "Diagnosis, Active: steroid induced diabetes"
- AND: "Medication, Dispensed: Medications indicative of diabetes"
- <= 2 year(s) starts before or during "Measurement end date"
-
Numerator =
- AND: "Procedure, Performed: eye exam" <= 1 year(s) starts before or during "Measurement end date"
- AND:
- AND:
- AND NOT: "Diagnosis, Active: Diabetic Retinopathy" > 1 year(s) starts before or during "Measurement end date"
- AND NOT: "Diagnosis, Active: Diabetic Retinopathy" <= 2 year(s) starts before or during "Measurement end date"
- AND: "Procedure, Performed: eye exam" > 1 year(s) starts before or during "Measurement end date"
- AND: "Procedure, Performed: eye exam" <= 2 year(s) starts before or during "Measurement end date"
-
Denominator Exceptions =
- AND: "Diagnosis, Active: Diabetic Retinopathy" <= 1 year(s) starts before start of "Measurement end date"
-
"Diagnosis, Active: diabetes" using "diabetes Value Set GROUPING (2.16.840.1.113883.3.464.0001.37)"
-
"Diagnosis, Active: Diabetic Retinopathy" using "Diabetic Retinopathy Value Set GROUPING (2.16.840.1.113883.3.464.0001.215)"
-
"Diagnosis, Active: gestational diabetes" using "gestational diabetes Value Set GROUPING (2.16.840.1.113883.3.464.0001.67)"
-
"Diagnosis, Active: polycystic ovaries" using "polycystic ovaries Value Set GROUPING (2.16.840.1.113883.3.464.0001.98)"
-
"Diagnosis, Active: steroid induced diabetes" using "steroid induced diabetes Value Set GROUPING (2.16.840.1.113883.3.464.0001.113)"
-
"Encounter: Encounter acute inpatient or ED" using "Encounter acute inpatient or ED Value Set GROUPING (2.16.840.1.113883.3.464.0001.42)"
-
"Encounter: Encounter non-acute inpatient and outpatient" using "Encounter non-acute inpatient and outpatient Value Set GROUPING (2.16.840.1.113883.3.464.0003.1142)"
-
"Medication, Dispensed: Medications indicative of diabetes" using "Medications indicative of diabetes Value Set GROUPING (2.16.840.1.113883.3.464.0001.94)"
-
"Patient Characteristic: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Procedure, Performed: eye exam" using "eye exam Value Set GROUPING (2.16.840.1.113883.3.464.0001.242)"
- "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"
- "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)"