Uploaded image for project: 'eCQM Issue Tracker'
  1. eCQM Issue Tracker
  2. CQM-5800

Follow-Up after removal of denominator exclusion for diagnosis for depression

XMLWordPrintable

    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Hide
      ​​Thank you for your inquiry regarding CMS2v12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. As you noted, the measure logic requires that a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter for a positive depression screening in order to meet the numerator criteria. Therefore, in the scenario you provided, if the patient is screened during the 2/1/2024 encounter and the screening is positive, the provider should document a follow-up plan for this positive depression screening, even though the patient has an active prescription for antidepressant medication.

      Refer to the following value sets for appropriate follow-up plan documentation:

      "Follow Up for Adolescent Depression" (2.16.840.1.113883.3.526.3.1569)

      "Follow Up for Adult Depression" (2.16.840.1.113883.3.526.3.1568)

      "Referral for Adolescent Depression" (2.16.840.1.113883.3.526.3.1570)

      "Referral for Adult Depression" (2.16.840.1.113883.3.526.3.1571)

      "Adolescent Depression Medications" (2.16.840.1.113883.3.526.3.1567)

      "Adult Depression Medications" (2.16.840.1.113883.3.526.3.1566)

      If there is no follow-up plan documentation for a positive depression screening on the date of or up to two days after the date of the qualifying encounter, the patient would not meet the numerator criteria. Keep in mind that the measure assesses the most recent depression screening completed either during the qualifying encounter or within the 14 calendar days prior to that encounter. Therefore, if another depression screening is performed for this patient and documented as positive or negative after the 2/1/2024 encounter, the most recent screening and follow-up plan documentation will be assessed for the numerator.
      Show
      ​​Thank you for your inquiry regarding CMS2v12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. As you noted, the measure logic requires that a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter for a positive depression screening in order to meet the numerator criteria. Therefore, in the scenario you provided, if the patient is screened during the 2/1/2024 encounter and the screening is positive, the provider should document a follow-up plan for this positive depression screening, even though the patient has an active prescription for antidepressant medication. Refer to the following value sets for appropriate follow-up plan documentation: "Follow Up for Adolescent Depression" (2.16.840.1.113883.3.526.3.1569) "Follow Up for Adult Depression" (2.16.840.1.113883.3.526.3.1568) "Referral for Adolescent Depression" (2.16.840.1.113883.3.526.3.1570) "Referral for Adult Depression" (2.16.840.1.113883.3.526.3.1571) "Adolescent Depression Medications" (2.16.840.1.113883.3.526.3.1567) "Adult Depression Medications" (2.16.840.1.113883.3.526.3.1566) If there is no follow-up plan documentation for a positive depression screening on the date of or up to two days after the date of the qualifying encounter, the patient would not meet the numerator criteria. Keep in mind that the measure assesses the most recent depression screening completed either during the qualifying encounter or within the 14 calendar days prior to that encounter. Therefore, if another depression screening is performed for this patient and documented as positive or negative after the 2/1/2024 encounter, the most recent screening and follow-up plan documentation will be assessed for the numerator.
    • CMS0002v12
    • If Follow Up logic isn't updated patients with depression who still screen positive for depression but are already engaged in treatment will not be included in the numerator lowing provider's scores.

      It appears that starting in 2024, CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up,Plan a current or historical diagnosis of depression will no longer exclude a patient from the measure (see: https://oncprojectracking.healthit.gov/support/browse/CQM-5610). In the below scenario would the patient be in the numerator of the measure for year 2024? Why or why not?

       

      on 12/1/2023 a patient is diagnosed with depression and the provider writes a 6 month prescription for a medication in the "Adult Depression Medications" (2.16.840.1.113883.3.526.3.1566) value set. Then on 2/1/2024 the patient has a qualifying encounter with the same provider. At this encounter the patient is screened for depression and screens positive for depression. Due to the patient already having an active anti-depressant medication no specific follow up is completed on 2/1/2024. No additional qualifying encounters occur the rest of 2024. 

       

      The measure logic would seem to indicate that because no follow up is done on the same day of the positive depression screening the patient would not be in the numerator, but because the patient is already on active anti-depressant medication it seems like additional follow up should not be required to count the patient in the numerator. 

       

            edave Mathematica EC eCQM Team
            pgarman@wphca.org Parker Garman
            Votes:
            0 Vote for this issue
            Watchers:
            6 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: