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  1. eCQM Issue Tracker
  2. CQM-6771

Documentation/Interpretation clarification for depression screening for patients with Depression

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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    • Kelly Bitionio
    • 916-540-0620
    • CommonSpirit Health
    • Hide
      Thank you for your inquiry regarding CMS2v13 Preventative Care and Screening: Screening for Depression and Follow-Up Plan.

      For patients that are already being treated for depression and are advised to continue their depression care plan, clinicians can consider mapping to the following codes:

      SNOMED CT 410234004 (Management of mental health treatment (procedure)) OR

       SNOMED CT 410232000 (Mental health treatment assessment (procedure)).

      These codes are also found:

      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.

       

      These value sets are found on The National Library of Medicine's Value Set Authority

      Center (VSAC), https://vsac.nlm.nih.gov/. The VSAC provides downloadable access to all official versions of value sets content contained in the eCQM specifications.

      Additionally, a Known Issue(KI) has been created to address this issue and can be found by visiting the eCQI Resource Center: https://oncprojectracking.healthit.gov/support/browse/EKI-22.

      We do not provide interpretation of negative or positive screening results due to the number of different screening tools. This measure is not prescriptive as to which depression screening tool is used and the measure guidance provides a list of examples of standardized depression screening tools, including the Patient Health Questionnaire (PHQ-9).

      The list of examples is not all-inclusive and reflects a subset of all of the standardized depression screening tools that providers may use to screen for depression to meet the measure intent. The guidance does require the measures used are: “A normalized and validated depression screening tool developed for the patient population in which it is being utilized”. Please refer to the screening tool itself or contact the tooling author for clarification/interpretation of the results.



      Show
      Thank you for your inquiry regarding CMS2v13 Preventative Care and Screening: Screening for Depression and Follow-Up Plan. For patients that are already being treated for depression and are advised to continue their depression care plan, clinicians can consider mapping to the following codes: SNOMED CT 410234004 (Management of mental health treatment (procedure)) OR  SNOMED CT 410232000 (Mental health treatment assessment (procedure)). These codes are also found: 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.   These value sets are found on The National Library of Medicine's Value Set Authority Center (VSAC), https://vsac.nlm.nih.gov/ . The VSAC provides downloadable access to all official versions of value sets content contained in the eCQM specifications. Additionally, a Known Issue(KI) has been created to address this issue and can be found by visiting the eCQI Resource Center: https://oncprojectracking.healthit.gov/support/browse/EKI-22 . We do not provide interpretation of negative or positive screening results due to the number of different screening tools. This measure is not prescriptive as to which depression screening tool is used and the measure guidance provides a list of examples of standardized depression screening tools, including the Patient Health Questionnaire (PHQ-9). The list of examples is not all-inclusive and reflects a subset of all of the standardized depression screening tools that providers may use to screen for depression to meet the measure intent. The guidance does require the measures used are: “A normalized and validated depression screening tool developed for the patient population in which it is being utilized”. Please refer to the screening tool itself or contact the tooling author for clarification/interpretation of the results.
    • CMS0002v13
    • Hide
      Need to educate and prepare our clinician s on the most appropriate documentation expectations. 2024 Specification for depression screening and follow up measure no longer has the exclusion of depression diagnosis. Per APA guidelines, this patient is no longer eligible for screening, but rather is being assessed for remission or relapse so how do we differentiate in our reporting?
      Show
      Need to educate and prepare our clinician s on the most appropriate documentation expectations. 2024 Specification for depression screening and follow up measure no longer has the exclusion of depression diagnosis. Per APA guidelines, this patient is no longer eligible for screening, but rather is being assessed for remission or relapse so how do we differentiate in our reporting?

      The PHQ 9 is a standardized screening tool used to identify people at risk of developing or having depression.  The PHQ 9 is also used in monitoring the treatment progress for those patients that have a diagnosis of depression.  With the removal of the exclusion of a diagnosis of depression, what is the most appropriate way to document results of  this follow-up assessment with a patient that is already identified as depressed in the following scenario? Per APA guidelines, this patient is no longer eligible for screening, but rather is being assessed for remission or relapse so how do we differentiate in our reporting? 
       
      The PHQ 9 score for a patient currently diagnosed with depression is low (indicating effective management).  Is it best to document:  

      • Negative screening with Depression   

                                       OR * Positive depression with remission

      The PHQ 9 score for a patient currently diagnosed with depression is greater than 4 * Is this reported as remission, relapse, or well-controlled depression? Per DSM-IV and APA guidelines, this would not ** be considered recalcitrant to treatment

      • What further documentation is required for follow-up when the patient is already being actively treated?
      •  We wish for clarification, is this a negative or positive screen?

      We liken this to the diabetic patient who now has an A1c within normal range- still a diabetic but one whose diabetes is under good control. 
      Thank you for any guidance you can provide,

            edave Mathematica EC eCQM Team
            kelly.bitoniio Kelly Bitonio
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