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  1. eCQM Issue Tracker
  2. CQM-1652

Questioning a wording change in the Denominator Exclusion for CMS 2v5.

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Minor Minor
    • Measure
    • None
    • Judi Dorsey
    • Medent EHR
    • Require confirmation of which data element the Active Dx of Depression must be compared against for the Denominator Exclusions in CMS 2v5 - the Depression Screening or the Depression Encounter code.
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      The changes to the denominator exclusion logic between CMS2v4 and CMS2v5 were adopted to better align the measure's intent. The intent of the measure is to capture patients that do not have an existing diagnosis of depression or bi-polar. In order to meet the exclusion criteria it should not be necessary for screening to be documented as it was specified in CMS2v4.

      The exclusion criteria in CMS2v5 are now associated with a qualifying encounter. In order to be included in the measure denominator there should be at least one encounter during the measurement period where a diagnosis of depression or bi-polar is not made prior to that encounter.
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      The changes to the denominator exclusion logic between CMS2v4 and CMS2v5 were adopted to better align the measure's intent. The intent of the measure is to capture patients that do not have an existing diagnosis of depression or bi-polar. In order to meet the exclusion criteria it should not be necessary for screening to be documented as it was specified in CMS2v4. The exclusion criteria in CMS2v5 are now associated with a qualifying encounter. In order to be included in the measure denominator there should be at least one encounter during the measurement period where a diagnosis of depression or bi-polar is not made prior to that encounter.
    • CMS2v5/NQF0418

      Regarding the Denominator Exclusions for CMS 2v4 vs CMS 2v5, the wording differs as to which element the Active Dx of Depression is compared against. In CMS 2v4, a patient would meet the Denominator Exclusions if they had an Active Dx of Depression that started before start of Occurrence A of Risk Category Assessment: Adolescent/Adult Depression Screening. In CMS 2v5, a patient would meet the Denominator Exclusions if they had an Active Dx of Depression that started before start of/overlapped Occurrence A of Encounter, Performed: Depression Screening Encounter Codes. It looks as if the Dx must now be compared against the date and time for the Encounter code as opposed to the time and date of the Depression Screening. Is this correct? It would seem more accurate to have the Dx compared against the Screening to ensure a Screening was indeed performed. Comparing against the Encounter code does not ensure the Screening was performed. Please advise.

            edave Mathematica EC eCQM Team
            woodstep67 Judi Dorsey
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