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  2. CQM-6150

2024 CMS2v13 - Issue in Depression screening Followup timing

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      ​​Thank you for questions on CMS2v13 Preventive Care and Screening: Screening for Depression and Follow-Up Plan. For Question 1, the logic for the "Intervention, Performed: Follow Up for Adolescent Depression" allows for follow-up plan be documented on the date of or up to two days after the date of the qualifying encounter. The QDM datatype "Intervention, Performed" can use the following available timings: relevant dateTime, relevantPeriod and author dateTime. If the author dateTime is used for "Intervention, Performed: Follow Up for Adolescent Depression" (i.e., the time "Follow Up for Adolescent Depression" is documented in the EHR), it can be captured on the date of or up to two days after the date of the qualifying encounter.
      For Question 2, thank you for bringing this to our attention. We replaced value set Patient Declined value set (2.16.840.1.113883.3.526.3.1582) with direct reference code SNOMED CT code (720834000) based on applicability of a single code to represent the clinical data. We will consider updating the SNOMED in a future release, but in the meantime, please use SNOMED CT code (720834000).

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      ​​Thank you for questions on CMS2v13 Preventive Care and Screening: Screening for Depression and Follow-Up Plan. For Question 1, the logic for the "Intervention, Performed: Follow Up for Adolescent Depression" allows for follow-up plan be documented on the date of or up to two days after the date of the qualifying encounter. The QDM datatype "Intervention, Performed" can use the following available timings: relevant dateTime, relevantPeriod and author dateTime. If the author dateTime is used for "Intervention, Performed: Follow Up for Adolescent Depression" (i.e., the time "Follow Up for Adolescent Depression" is documented in the EHR), it can be captured on the date of or up to two days after the date of the qualifying encounter. For Question 2, thank you for bringing this to our attention. We replaced value set Patient Declined value set (2.16.840.1.113883.3.526.3.1582) with direct reference code SNOMED CT code (720834000) based on applicability of a single code to represent the clinical data. We will consider updating the SNOMED in a future release, but in the meantime, please use SNOMED CT code (720834000).
    • CMS0002v13

      Question#1

      2024 CMS2v13 - Issue in  Depression screening Followup timing. Below is the specifications for adolescent Followup criteria. The same issue is with Adult criteria as well. 

      Most Recent Adolescent Depression Screening Positive and Follow Up Provided
      from
        "Most Recent Adolescent Depression Screening" LastAdolescentScreen,
        "Follow Up Intervention for Positive Adolescent Depression Screening" FollowUpPositiveAdolescentScreen,
        "Qualifying Encounter During Measurement Period" QualifyingEncounter
        where Global."NormalizeInterval" ( LastAdolescentScreen.relevantDatetime, LastAdolescentScreen.relevantPeriod ) 14 days or less on or before day of start of QualifyingEncounter.relevantPeriod
          and LastAdolescentScreen.result ~ "Depression screening positive (finding)"
          and ( start of Global."NormalizeInterval" ( FollowUpPositiveAdolescentScreen.relevantDatetime, FollowUpPositiveAdolescentScreen.relevantPeriod ) during QualifyingEncounter.relevantPeriod
              or FollowUpPositiveAdolescentScreen.authorDatetime 2 days or less on or after day of 
              end of QualifyingEncounter.relevantPeriod
          )
          and Coalesce(start of Global."NormalizeInterval"(FollowUpPositiveAdolescentScreen.relevantDatetime, FollowUpPositiveAdolescentScreen.relevantPeriod), FollowUpPositiveAdolescentScreen.authorDatetime)during "Measurement Period"

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      Here, Followup Relevantdatetime or Relevant Period is valid if documented 'during encounter'.

      But, Followup Authordatetime is valid if documented '2 days or less on or after day of encounter'.

       

      So, If the prescribed followup is 'Intervention Performed: Follow Up for Adolescent Depression', then it has to be during encounter ONLY.

      But if the prescribed followup is 'Medication, Order: Adolescent Depression Medications or Intervention, Order:Referral for Adolescent Depression' , then it can be '2 days or less on or after day of encounter'.

      This logic is conflicting the numerator description, where all 3 followups should be allowed to be '2 days or less on or after day of encounter'.

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            edave Mathematica EC eCQM Team
            priyankamurthy Priyanka Murthy
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