New issue - CMS2v13 differs from every prior instance of the measure, by REMOVING prior diagnosis of depression from the exclusion list. Thus, all patients 12 and older, even those who are diagnosed with, and/or being treated for depression would now be subject to depression screening. The only exclusion is for bipolar disorder. I hope I am misreading this 2024 update, as if not, how does this make sense?

Screening is designed for people who don't already have the diagnosis.

And assuming the measure steward feels differently - what is the appropriate follow-up action for someone with depression who is already in treatment? Referring for treatment? Sounds like wasted effort JUST to "treat" the measure - and does nothing for patients.

Second issue - and I have raised this before. For other screening measures where a follow-up is done and documented, there is clarity that repeated follow-ups are not necessary during the measure year... To the contrary, for both BMI and smoking / tobacco use - documented follow-up / guidance / cessation activity (for tobacco use) - appropriate follow-up during the measure year counts. I recall guidance on this site that it made no sense to require it after each screening (BMI and smoking/tobacco screening are often done multiple times during the measure year) - something to the effect... "if the patient has already been referred to a nutritionist / quitline, etc. why would you re-refer after each screening - they are already in treatment..." And yet, with depression screening - a follow-up is required after every screening.

And please don't point out that depression screening is only required by the measure annually... That's also true for BMI and tobacco. Clinicians will (thank God) screen not just for floor measure requirements - but when they feel it's appropriate. So no, telling clinicians to stop following clinical judgment is not an acceptable answer.

And yet, placing an unreasonable burden on clinicians who screen for depression more than once during the CY is what this measure does. Perhaps there is a satisfier that is the equivalent of "continue seeing the same person I referred you to last week/month, etc." But what's the point - the patient was screened and appropriately followed-up; but without burdensome click-boxing that adds nothing to patient care - the clinician fails the measure.