Our team submitted a question a few years ago, but the issue is still occurring.

We are noticing in data validation activities that depression screenings performed in episode-based visits are not meeting numerator conditions. Prenatal care, cardiac rehab, or annual Medicare Wellness visits may be delivered in multiple visits, but only billed once.

For instance, a patient has an initial prenatal visit done with a negative depression screening on June 8th, but her prenatal visits are billed on August 8th. She is failing the depression screening measure because her depression screening was not done on the date of the billed episode August 8th.

Another example is when a nurse sees a patient on August 1st to start the Medicare Wellness visit and performs a depression screening. Results are negative. The patient sees the provider several days later to finish out the visit. Because the depression screening was not done on the day of the visit, the patient does not meet numerator conditions. Our EHR vendor does not give us an option to map the prenatal visits, CV Rehab therapy visits, or nurse Medicare Wellness visits.

We believe these situations meet the intent of the measure: to screen patients in a setting where accurate diagnosis, effective treatment, and appropriate follow up can occur.

Please consider simplifying the numerator statement to allow the latest depression screening and review to occur any time during the measurement period and not tie it to a particular visit.