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9.15.2014 Comprehensive Diabetes Care For the eye exam indicator, is documentation of hypertensive retinopathy treated differently from diabetic retinopathy? If there is documentation that a member was negative for hypertensive retinopathy in the year prior to the measurement year, is this compliant?

 Although the two diagnoses are clinically different, hypertensive retinopathy is not treated differently from diabetic retinopathy for the CDC measure. The intent of the eye exam indicator is to ensure that members with evidence of any type of retinopathy have an eye exam annually, while members who remain free of retinopathy (i.e., the retinal exam was negative for retinopathy) are screened every other year. If it is clear that a retinal or dilated eye exam was performed by an eye care professional in the year prior to the measurement year and there is documentation indicating that the member is negative for hypertensive retinopathy, this can count as compliant.


ALL 2015