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  1. eCQM Issue Tracker
  2. CQM-5804

CMS2v11 ICD-10 updates effective during the measurement year

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      Thank you for your inquiry regarding CMS2v11 Preventive Care and Screening: Screening for Depression and Follow-Up Plan. As you noted, code F32.A was added to the “Depression Diagnosis” value set (2.16.840.1.113883.3.600.145) during the eCQM annual update published 05/05/22 for Performance Year 2023 for CMS2v12. This code is not present in the value set used for CMS2v11 for Performance Year 2022 because F32.A became effective in October of 2021 after the eCQM publication. To ensure the stability of value sets and codes used in each publication, we are unable to update value sets in order to reflect ICD-10 coding updates that occur following publication. Please continue to use codes as specified for each version for performance years 2022 and 2023. We hope this helps.
      Show
      Thank you for your inquiry regarding CMS2v11 Preventive Care and Screening: Screening for Depression and Follow-Up Plan. As you noted, code F32.A was added to the “Depression Diagnosis” value set (2.16.840.1.113883.3.600.145) during the eCQM annual update published 05/05/22 for Performance Year 2023 for CMS2v12. This code is not present in the value set used for CMS2v11 for Performance Year 2022 because F32.A became effective in October of 2021 after the eCQM publication. To ensure the stability of value sets and codes used in each publication, we are unable to update value sets in order to reflect ICD-10 coding updates that occur following publication. Please continue to use codes as specified for each version for performance years 2022 and 2023. We hope this helps.
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      Good morning,

      Our project team received the inquiry below from an external partner regarding the following measure: Preventative Care and Screening: Screening for Depression and Follow-Up (CMS2v11). We would appreciate any insight your team is able to provide on this inquiry.
      Show
      Good morning, Our project team received the inquiry below from an external partner regarding the following measure: Preventative Care and Screening: Screening for Depression and Follow-Up (CMS2v11). We would appreciate any insight your team is able to provide on this inquiry.

      Inquiry: We seek guidance on updated ICD-10 diagnosis codes effective in the measurement period and also effective after the publication of the reporting year’s value sets. Specifically, F32.A diagnosis code for Depression, unspecified is not present in “eCQM Update 2021-05-06” expansion version for reporting year 2022, presumably because its clinical effective date was October of 2021 (after the eCQM version publication). F32.A replaced F32.9 on Oct. 1, 2021. F32.A is included for reporting year 2023 which uses “eCQM Update 2022-05-05.”

      Examining our Q-CMS2v11 2022 denominator cases, we are finding many patients with a diagnosis code of F32.A. These patients meet the Denominator Exclusion criteria but are not being captured by the “Depression Diagnosis” value set (2.16.840.1.113883.3.600.145, eCQM Update 2021-05-06 version). The result will be an underreporting of denominator exclusions, patients with a history of depression diagnosis. All 2021 and 2022 F32.A Depression diagnoses are missed.

      We are seeking approval to include F32.A as an ICD-10 code indicating diagnosis of depression for Q-CMS2 2022 reporting year.

      The omission of F32.A from the 2022 reporting year value sets may also affect other measures that use the “Depression Diagnosis” value set 2.16.840.1.113883.3.600.145.

      In general, how are ICD-10 updates effective in the measurement year but not reflected in the value set publication (dated earlier) handled? Is there an addendum to allow for the updated ICD-10 codes that are effective in the measurement period?
      In the case of Depression, unspecified, F32.9 is in the 2022 associated value set but F32.9’s replacement F32.A, is not. We would like to use F32A in the 2022 reporting year to accurately capture a history of depression diagnosis.

       

      Your guidance on answering this inquiry would be most appreciated. Thank you.

            edave Mathematica EC eCQM Team
            taltman Tara Altman (Inactive)
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