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  2. CQM-6749

CMS2 Medical Exception

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Leslie Calihman Alabi
    • Duke Connected Care
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      Thank you for inquiry on CMS2v13: Preventive Care and Screening: Screening for Depression and Follow-Up Plan.

      The intent of the "medical reason" Denominator Exception is for situations where the patient has “cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status”. Thus, if the patient has cognitive, functional, or motivational limitations that may impact accuracy of results or delaying treatment would jeopardize the patient's health status, then it would be appropriate to use the medical reason denominator exception.
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      Thank you for inquiry on CMS2v13: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. The intent of the "medical reason" Denominator Exception is for situations where the patient has “cognitive, functional, or motivational limitations that may impact accuracy of results; patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status”. Thus, if the patient has cognitive, functional, or motivational limitations that may impact accuracy of results or delaying treatment would jeopardize the patient's health status, then it would be appropriate to use the medical reason denominator exception.
    • CMS0002v13

      Encounter codes used in our urgent care clinics are among those found in the value set for Encounter to Screen for Depression; however, proactive depression screening is not part of the urgent care workflow due to the acute, time-sensitive nature of those visits.

      Would it be reasonable to document a medical exception for ALL urgent care visits (unless a patient is presenting with depression symptoms) given that the definition of medical reason for not screening found in the CMS-2 specifications includes, "patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient's health status"?

            edave Mathematica EC eCQM Team
            lcalabi Leslie Alabi (Inactive)
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