The intent of the measure is to determine if the patient is receiving appropriate treatment after the diagnosis of Alcohol or Drug Dependence is made. This is why the measure assesses if there is a visit within 14 days after the diagnosis starts. The measure requires a total of 4 visits with the first visit being where the diagnosis of dependence is made. The second visit is for initiation of treatment within 14 days of the diagnosis. The third and fourth visits are for continued treatment and should be within 30 days of the initiation visit.   If the Eligible Clinician is billing a psychotherapy visit at the time of the diagnosis, the patient would be in the measure, as the diagnosis was associated with psychotherapy visit. Our intent is that there are always four visits required regardless of the provider type. Three visits are required only when the denominator visit is a hospitalization.

The logic below requires that the first treatment encounter be performed after the initial office where the diagnosis is documented. In a workflow where the EC is a psychotherapist they may record the alcohol/substance abuse diagnosis during their initial face-to-face encounter which is also billed as a psychotherapy visit. Thus the patient will require 4 visits to count for numerator 2 if seen by a specialist, rather than 3 visits if the initial visit is recorded by a different EC e.g. if they diagnosing EC and the psychotherapist share the same chart. $DrugDependenceTreatmentOrPsychVisit = Union of: "Encounter, Performed: Alcohol and Drug Dependence Treatment" "Encounter, Performed: Psych Visit - Psychotherapy" <= 14 day(s) starts after start of $FirstAlcoholDrugDependenceDx Recommended change <= 14 day(s) starts after start or concurrent with $FirstAlcoholDrugDependenceDx