> ## Documentation Index > Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt > Use this file to discover all available pages before exploring further. # [CMS131v14] Diabetes: Eye Exam (MIPS 2026) > Elation supports the automatic calculation of CMS131v14, Diabetes: Eye Exam. ## Measure Details Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period ## Measure Parameters ### Numerator Patients with an eye screening for diabetic retinal disease. This includes diabetics who had one of the following: * Diabetic with a diagnosis of retinopathy that overlaps the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period * Diabetic with no diagnosis of retinopathy overlapping the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the year prior to the measurement period **Denominator** Patients 18-75 years of age by the end of the measurement period with diabetes with a visit during the measurement period. ### Exclusions/Exceptions * Exclude patients who are in hospice care for any part of the measurement period. * Exclude patients receiving palliative care for any part of the measurement period. * Exclude patients 66 and older by the end of the measurement period who are living a nursing home any time on or before the end of the measurement period. * Exclude patients who have bilateral absence of eyes any time during the patient’s history through the end of the measurement period. * Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: * Advanced illness diagnosis during the measurement period or the year prior * OR taking dementia medications during the measurement period or the year prior ## Elation Workflows Elation has implemented dedicated workflows that reflect standardized requirements we do not control for certification to ensure structured and reportable tracking of measure specifications for supported electronic Clinical Quality Measures. To optimize performance per the specifications, please adhere precisely to the workflows outlined in the referenced Help Center article. ### Documenting diabetes diagnosis in the patient's chart Patients must have an active diagnosis of diabetes recorded in their chart during the measurement period. Elation looks for a diabetes ICD-10 code in either a visit note for the measurement period or in the Problem List. To add a diabetes diagnosis to the Problem List: | **1** | Go to the Problem List and click **+ Add Problem** . | | ----- | ---------------------------------------------------------------------------------- | | **2** | Search for the appropriate diabetes diagnosis and then select it from the results. | | **3** | Adjust the **Title** and **Dx Date** as needed. | | **4** | Click **Save** . | ![Image](https://lh5.googleusercontent.com/dk6aBv2MaXO_0RiKLntHJFGs8CTzuNNWWHkNn-h_4VyPfBtOsgx_ORH2f3O7LKuttBOblmKaiBrklbbnYL2V5ZBa_F0cpQtMbqblUPf4G-UQkAmbaAxl1qGm-DRxSKwMPPN83zQB) ### Documenting measure requirements using a Clinical Reminder in a visit note | **1** | Click **Address** in the **Diabetic Eye Exam is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: | | ------ | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2a** | To meet the numerator requirements immediately by documenting a diabetic eye exam for the patient: Click **Document existing exam results**. • Record the eye exam and results: • Click **Save New**. | | **2b** | To move closer to meeting the numerator requirements: Click **Refer to ophthalmologist** to create a referral order for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding referral. Once the eye exam is completed and you have the results, return to **Step 2a**. | Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened. ![Image](https://lh4.googleusercontent.com/XetfPYBsX_KGJrHzbca1Q13dvQ50-GtKbqXnSi06YqTxISakRSZcczynBKlJIBGC1yt5WY1t129tIphZKgMgx7Bd3SBTRmznnOLZsv9RrZDzHEnoSBq5Mou0tj2UnM4_BsDW0C6i) ### Documenting measure requirements using the Health Maintenance section | **1** | Click on Diabetic Eye Exam in the **Health Maintenance** section of the **Clinical Profile** . | | ----- | ---------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2** | Enter the date of the eye exam in the **Date** field. | | **3** | Select one of the appropriate document tags below in the **Type** field: **Eye Exam (negative for retinopathy)** • **Eye Exam (positive for retinopathy)** | | **4** | Click **+ Link a report to this item** to link the eye exam report in the patient's chart to the record if available. | | **5** | Click **Save New**. | ![Image](https://lh5.googleusercontent.com/TZ_QP_UlXUYcaZsHZIX9L35nFyz-F6s9Zxi2EB4zKTqdEsI4hgTqbhzQHiSivMt5WdgbXvQjtfiV7l1Do0KPhngxGrCPeJm-YQBdRK8_HLF2VsISGQq504aWh8GQkaDcWEh_p8UU) ### Documenting measure requirements from an eye exam report | **1** | Open the eye exam report in the patient's chart. | | ----- | ----------------------------------------------------------------------------------------------------------------------------------------------------------------- | | **2** | Click **Actions** -> **Edit Details** . | | **3** | Go to the **Tags** field and select one of the appropriate document tags below: **Eye Exam (negative for retinopathy)** • **Eye Exam (positive for retinopathy)** | | **4** | Click **Save** . | [Click here for more details about Document Tags](/articles/tag-reports-and-notes-with-document-tags). ### Documenting exclusions/exceptions | **Exclusion/Exception** | **Steps** | | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from the list below: EXCLUSION: HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE • EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE | | Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** . | | Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home**. | | Exclude patients who have bilateral absence of eyes any time during the patient’s history through the end of the measurement period. | Add the problem **Anophthalmos of both eyes (Q11.1)** in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. | | Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: Advanced illness diagnosis during the measurement period or the year prior • OR taking dementia medications during the measurement period or the year prior | See below. | **Documenting frailty** To document frailty in Elation using 1. Frailty diagnosis, advanced illness codes and/or medications 2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv). 3. Record one of the following: 4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.xlsx). 5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.xlsx). 6. a dementia medication in the patient's chart. 7. A frailty device code 8. Click **+ Tag** at the bottom of the visit note draft. 9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.xlsx). 10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed. ## Measure Information Diabetes is the seventh leading cause of death in the United States. In 2017, diabetes affected approximately 34 million Americans (10.5 percent of the U.S. population) and killed approximately 84,000 people (Centers for Disease Control and Prevention \[CDC], 2020a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2020b). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, and amputation of feet or legs, and premature death (CDC, 2018). In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34 percent increase from the estimated $245 billion spent on diabetes in 2012 (American Diabetes Association, 2018). Diabetic retinopathy is progressive damage to the small blood vessels in the retina that may result in loss of vision. It is the leading cause of blindness in adults between 20-74 years of age. Approximately 4.1 million adults are affected by diabetic retinopathy (CDC, 2020c). [Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2026/cms0131v14) ## Attachments * [Advanced Illness Codes](/files/advanced-illness-codes-eye-exam.xlsx) * [Frailty Codes](/files/frailty-codes-eye-exam.csv) * [Frailty Descriptions](/files/advanced-illness-codes-eye-exam.xlsx) ## Related Articles * [MIPS (2026) - Quality Category](/articles/MIPS-2026-Quality-Category) * [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards) * [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures) * [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags) * [MIPS (2026) Overview](/articles/MIPS-2026-Overview)