Measure CMS 2: Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan (PQRS 130/NQF0419): The above referenced measure specification CMS2v1 is not the most current and not reflective of the text you have provided in the attachment. The most current HQMF, CMS2v2, is attached for your convenience”. Answer to Denominator question: a. Yes, the measure is looking to exclude all patients with an active diagnosis of depression or bipolar disorder that started before a depression screen. The depression screen would not be performed because the patient would NOT be eligible for the measure if he/she had an active diagnosis. b. In addition, if during the depression screen or as the result of the depression screen, a patient was found to be depressed or bipolar, the patient would not be excluded at that time but would be excluded the following year for the measure due to an active diagnosis of depression or bipolar disorder. This measure is a depression screening and follow-up measure only. Answer to Numerator question: a. The Numerator instructions specify that the follow-up interventions must be documented DURING the encounter in which the depression screening occurred. b. The referenced text in the Numerator logic “<= 1 day(s) after start of Occurrence A of Risk Category Assessment: Adolescent Depression Screening (result: ‘Positive Depression Screening’) is referring to the INTERVENTION performed. The Intervention can start <= 1 day after the patient has a positive screen for depression documented. Therefore, this logic is referring to the Intervention NOT the depression screening. Logic for CMS2v2 (2014): Population criteria • Initial Patient Population = o AND: "Patient Characteristic Birthdate: birth date" >= 12 year(s) starts before start of "Measurement Period" o AND: "Occurrence A of Encounter, Performed: Depression Screening Denominator Encounter Codes New" during "Measurement Period" • Denominator = o AND: "Initial Patient Population" • Denominator Exclusions = o AND NOT:  OR: "Occurrence A of Diagnosis, Active: Depression diagnosis"  OR: "Occurrence A of Diagnosis, Active: Bipolar Diagnosis"  ends before start of "Occurrence A of Encounter, Performed: Depression Screening Denominator Encounter Codes New" o AND:  OR: "Occurrence A of Diagnosis, Active: Depression diagnosis"  OR: "Occurrence A of Diagnosis, Active: Bipolar Diagnosis"  starts before start of "Occurrence A of Encounter, Performed: Depression Screening Denominator Encounter Codes New" • Numerator = o AND: OR:  OR:  AND: "Patient Characteristic Birthdate: birth date" < 18 year(s) starts before start of "Occurrence A of Intervention, Performed: Adolescent Depression Screening"  AND: "Occurrence A of Intervention, Performed: Adolescent Depression Screening" during "Measurement Period"  AND:  OR: "Diagnosis, Active: Depression diagnosis"  OR: "Intervention, Result: Positive Depression Screening"  <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adolescent Depression Screening"  AND:  OR: "Intervention, Performed: Additional evaluation for depression - adolescent"  OR: "Intervention, Order: Referral for Depression Adolescent"  OR: "Medication, Order: Depression medications - adolescent"  OR: "Intervention, Performed: Follow-up for depression - adolescent"  OR: "Procedure, Performed: Suicide Risk Assessment"  <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adolescent Depression Screening"  OR:  AND NOT: "Diagnosis, Active: Depression diagnosis" <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adolescent Depression Screening"  AND: "Patient Characteristic Birthdate: birth date" < 18 year(s) starts before start of "Occurrence A of Intervention, Performed: Adolescent Depression Screening"  AND: "Occurrence A of Intervention, Performed: Adolescent Depression Screening" during "Measurement Period"  AND: "Intervention, Result: Negative Depression Screening" <= 1 day(s) starts after start of "Occurrence A of Encounter, Performed: Depression Screening Denominator Encounter Codes New" OR:  OR:  AND: "Patient Characteristic Birthdate: birth date" >= 18 year(s) starts before start of "Occurrence A of Intervention, Performed: Adult Depression Screening"  AND: "Occurrence A of Intervention, Performed: Adult Depression Screening" during "Measurement Period"  AND:  OR: "Diagnosis, Active: Depression diagnosis"  OR: "Intervention, Result: Positive Depression Screening"  <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adult Depression Screening"  AND:  OR: "Intervention, Performed: Additional evaluation for depression - adult"  OR: "Intervention, Order: Referral for Depression Adult"  OR: "Medication, Order: Depression medications - adult"  OR: "Intervention, Performed: Follow-up for depression - adult"  OR: "Procedure, Performed: Suicide Risk Assessment"  <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adult Depression Screening"  OR:  AND NOT: "Diagnosis, Active: Depression diagnosis" <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adult Depression Screening"  AND: "Patient Characteristic Birthdate: birth date" >= 18 year(s) starts before start of "Occurrence A of Intervention, Performed: Adult Depression Screening"  AND: "Occurrence A of Intervention, Performed: Adult Depression Screening" during "Measurement Period"  AND: "Intervention, Result: Negative Depression Screening" <= 1 day(s) starts after start of "Occurrence A of Intervention, Performed: Adult Depression Screening" • Denominator Exceptions = o AND:  OR: "Intervention, Performed not done: Medical reason contraindicated" for "Adolescent Depression Screening Grouping Value Set"  OR: "Intervention, Performed not done: Medical reason contraindicated" for "Adult Depression Screening Grouping Value Set"  OR: "Intervention, Performed not done: Patient Reason refused" for "Adolescent Depression Screening Grouping Value Set"  OR: "Intervention, Performed not done: Patient Reason refused" for "Adult Depression Screening Grouping Value Set"  during "Measurement Period"