​Brief Description of Measure:
CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up Plan:
Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter.

Description of Issue:
​​The "Follow Up for Adolescent Depression" (2.16.840.1.113883.3.526.3.1569) and "Follow Up for Adult Depression" (2.16.840.1.113883.3.526.3.1568) value sets used within the numerator logic of this measure are exactly the same.
 
The two value sets are paired with age requirements in the logic to ensure patients receive age appropriate follow up. However, since the value sets contain the exact same codes, we believe there may be an opportunity to simplify the logic and using a single value set to capture this coding, which will reduce the measure specification's complexity and align with best practices to harmonize and reduce redundancy across value sets.  
 
The measure developer is evaluating two options to determine which is the most feasible and reduces burden for implementation.

Proposed Solution:
Solution #1:​
Retain the "Follow Up for Adult Depression" (2.16.840.1.113883.3.526.3.1568) value set and remove ‘Adult’ from the value set name so that the title reads as “Follow Up for Depression.” Use this value set in place of the two former follow up value sets throughout the measure logic. 
 
Are there any clinical or technical concerns with this solution?  Are there any negative implications for making this change?

If the proposed change as noted above is deemed appropriate, the logic in the measure would appear as below:
Follow Up Intervention For Positive Adolescent Depression Screening
  ["Medication, Order": "Adolescent Depression Medications"]
   union ["Intervention, Order": "Referral for Depression"]
   union ["Intervention, Performed": "Follow Up for Depression"]
 
Follow Up Intervention for Positive Adult Depression Screening
  ["Medication, Order": "Adult Depression Medications"]
   union ["Intervention, Order": "Referral for Depression"]
   union ["Intervention, Performed": "Follow Up for Depression"]
 
OR
 
Solution #2:
Leave the value sets as they are (age-specific and separate), in case there are future coding or guidance updates that would require separation.

Rationale for Change:
The measure developer is seeking to simplify the measure specification and reduce burden on implementers reporting the measure. The CRP community's feedback will inform which proposed solution would achieve this.