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  1. eCQM Issue Tracker
  2. CQM-6541

CMS-2 Patient follow-up to return when and if necessary

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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    • Leslie Calihman Alabi
    • 919-660-0557
    • Duke Connected Care
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      Thank you for your inquiry on CMS2v12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan.

      Yes, you can use SNOMED CT 91310009 (Patient follow-up to return when and if necessary (procedure). This code is found in the Follow Up for Adolescent Depression (2.16.840.1.113883.3.526.3.1569) and Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568) value sets. However, self- referral to the same primary care physician (PCP) that completed the positive depression screen without documenting a follow-up plan to address the positive screen does not meet numerator criteria. Documented follow-up plans for a positive depression screening must include one or more of the following:

      * Referral to a provider for additional evaluation and assessment to formulate a follow-up plan for a positive depression screen - "Intervention, Order": "Referral for Adult Depression" OR "Intervention, Order": "Referral for Adolescent Depression"

      * Pharmacological interventions - "Medication, Order": "Adult Depression Medications" OR "Medication, Order": "Adolescent Depression Medications"

      * Other interventions or follow-up for the diagnosis or treatment of depression, such as, but not limited to behavioral health evaluation, psychotherapy, family or group therapy, support group, depression management program - "Intervention, Performed": "Follow Up for Adult Depression" OR "Intervention, Performed": "Follow Up for Adolescent Depression"

      You will need to document one of follow-up plan interventions above in the medical record when using use SNOMED CT 91310009 (Patient follow-up to return when and if necessary (procedure), to meet the numerator. Please feel free to reference the measure specifications, that can be found at the eCQI Resource Center https://ecqi.healthit.gov/
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      Thank you for your inquiry on CMS2v12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Yes, you can use SNOMED CT 91310009 (Patient follow-up to return when and if necessary (procedure). This code is found in the Follow Up for Adolescent Depression (2.16.840.1.113883.3.526.3.1569) and Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568) value sets. However, self- referral to the same primary care physician (PCP) that completed the positive depression screen without documenting a follow-up plan to address the positive screen does not meet numerator criteria. Documented follow-up plans for a positive depression screening must include one or more of the following: * Referral to a provider for additional evaluation and assessment to formulate a follow-up plan for a positive depression screen - "Intervention, Order": "Referral for Adult Depression" OR "Intervention, Order": "Referral for Adolescent Depression" * Pharmacological interventions - "Medication, Order": "Adult Depression Medications" OR "Medication, Order": "Adolescent Depression Medications" * Other interventions or follow-up for the diagnosis or treatment of depression, such as, but not limited to behavioral health evaluation, psychotherapy, family or group therapy, support group, depression management program - "Intervention, Performed": "Follow Up for Adult Depression" OR "Intervention, Performed": "Follow Up for Adolescent Depression" You will need to document one of follow-up plan interventions above in the medical record when using use SNOMED CT 91310009 (Patient follow-up to return when and if necessary (procedure), to meet the numerator. Please feel free to reference the measure specifications, that can be found at the eCQI Resource Center https://ecqi.healthit.gov/
    • CMS0002v12

      This is a follow-up question in relation to CQM-5687, in which the response noted that a PCP cannot use the code for "Patient follow-up to return when and if necessary (procedure)" as indicative of a follow-up plan for a positive screening. Since this code is listed in the follow-up plan value set for adolescents and adults, can you please explain the circumstances in which it would be appropriate/acceptable to use this code? Thank you.   

            edave Mathematica EC eCQM Team
            lcalabi Leslie Alabi
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