​Based on the information given for this scenario the patient would not be excluded. The intent of the exclusion logic is to capture patients who have been diagnosed with depression or bipolar prior to the encounter. The "overlaps" is meant to ensure that the diagnosis is still active during the encounter.

Below is the CMS2v7 Denominator Exclusion condition (from the specs): OR: "Diagnosis: Depression diagnosis" satisfies all: starts before start of ("Encounter, Performed: Depression Screening Encounter Codes" during "Measurement Period" ) overlaps ("Encounter, Performed: Depression Screening Encounter Codes" during "Measurement Period" ) Patient Scenario: Patient-1 has valid depression Dx present on 3/22/2018 during the valid "Depression Screening Encounter Codes" encounter which satisfies the overlap condition. But for same patient-1 there is no prior documentation of same Dx. Should we give credit towards the Exclusion?