CMS2v8 Intent of Depression diagnosis and related exclusion

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your inquiry. In the scenario described, the patient would be excluded from the measure’s denominator. The CQL timing operator “overlaps before” means the conditions starts before and extends into a qualifying encounter during the measurement period. If the diagnosis of depression or bipolar disorder is made prior to any eligible encounter and does not end prior to the encounter the patient should be excluded. Please let us know if you have any further questions.
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      Thank you for your inquiry. In the scenario described, the patient would be excluded from the measure’s denominator. The CQL timing operator “overlaps before” means the conditions starts before and extends into a qualifying encounter during the measurement period. If the diagnosis of depression or bipolar disorder is made prior to any eligible encounter and does not end prior to the encounter the patient should be excluded. Please let us know if you have any further questions.
    • CMS2v8/NQF418

      Please help in understanding the intent of Depression Diagnosis and the patient exclusion.

      If a eligible patient has a depression screening during the qualifying encounter on 15th Jan of the measurement year which resulted as a positive screen. The patient was also given pharmacologic treatment as a follow up. Hence this patient qualifies for the numerator criteria.

      Due to a positive screen, the provider also recorded a Depression diagnosis in the patients medical chart.

      Now if this same patient visits the provider again and have a qualifying encounter on 15th April of the measurement year, would this patient now go into an exclusion ? As the depression diagnosis entered on 15th Jan is started before and overlapping the qualifying encounter on 15th April ?

      Please clarify. Thank You ! 

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Mansi Shah
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