I am referencing a previous Jira ticket: CQM-5174.

The solution for CQM-5174 states that "...if a patient screens positive for depression, the provider subsequently provides a follow-up plan, and the patient refuses the follow-up plan, the patient meets the denominator exception. Codes that may be used to document patient refusal are included in the "Patient Declined" (2.16.840.1.113883.3.526.3.1582) value set..."

However, the CMS2v11 measure algorithm "Patient Declined" is only listed to be used in conjunction with the exception "Medical or Patient Reason For Not SCREENING".  There is no listed Denominator Exception for "patient refuses treatment or follow up plan". 

I am requesting that the exception of "patient refuses treatment and/or follow up plan" be added and associated with the "patient declined" value set for CMS2v12.