PQRS – Cataracts Measures Group

In 2012, a “Cataracts Measures Group” was added to the Physician Quality Reporting System (PQRS) program. A Measures Group is a subset of four or more measures that have a particular clinical condition or focus in common. Like other measure groups, the Cataracts Measures Group must be reported through a registry. This is an attractive option for cataract surgeons as it only requires reporting on thirty or more patients to achieve success with the PQRS program.

Outcome, the registry that many ophthalmologists have contracted with, recently released information on the process of reporting this measures group. We have been told that Outcome had to submit test cases to CMS, which has created a delay in beginning the process.

Because the measures in the measures group rely on patients completing a survey at the conclusion of their postoperative course, and the survey must be completed prior to year-end, the surgery must occur before September 30, 2012 to qualify for the 2012 PQRS program. This means that surgeons will need to report on thirty patients undergoing surgery between now and the end of September. This precludes some surgeons from reporting this measures group because they will not have thirty Medicare patients having cataract surgery during this window of time.

The four measures in this measure group are:

• Cataracts: 20/40 or Better Visual Acuity within 90 days Following Cataract Surgery (#191)
• Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures (#192).
• Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery (#303)
• Patient Satisfaction within 90 Days Following Cataract Surgery (#304)

Measure 303 requires patients to complete both a pre-operative and a post-operative survey. Measure 304 requires a second post-operative survey be completed, for a total of three surveys. Since not all patients may return all three surveys, there is a registry exclusion which allows for successful reporting as long as at least ONE patient returns the three different surveys.

Registry reporting continues to have a higher success rate than claims based reporting. If you are unable to utilize the measures group option, the registry can assist with reporting other measures.

For more information on the PQRS and E-Rx bonus programs, call us and order our Bonus Program Monograph ($99).