Thank you for inquiry for CMS2v12 Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Documentation of the medical or patient reason for not screening for depression must occur during any qualifying encounter during the measurement period. Please refer the logic in measure specifications ( https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS2v12.html ). There are specific codes to document medical reason or patient declined that are found in the value sets: "Medical Reason" (2.16.840.1.113883.3.526.3.1007) and "Patient Declined" (2.16.840.1.113883.3.526.3.1582). The value sets can be accessed from Value Set Authority Center (VSAC) ( https://vsac.nlm.nih.gov/ ). We hope this helps. Medical or Patient Reason for Not Screening Adult for Depression   ["Assessment, Not Performed": "Adult depression screening assessment"] NoAdultScreen   with "Qualifying Encounter During Measurement Period" QualifyingEncounter     such that NoAdultScreen.authorDatetime during QualifyingEncounter.relevantPeriod   where ( NoAdultScreen.negationRationale in "Patient Declined"       or NoAdultScreen.negationRationale in "Medical Reason"   )   Medical or Patient Reason for Not Screening Adolescent for Depression   ["Assessment, Not Performed": "Adolescent depression screening assessment"] NoAdolescentScreen   with "Qualifying Encounter During Measurement Period" QualifyingEncounter     such that NoAdolescentScreen.authorDatetime during QualifyingEncounter.relevantPeriod   where ( NoAdolescentScreen.negationRationale in "Patient Declined"       or NoAdolescentScreen.negationRationale in "Medical Reason"   )