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  2. CQM-7389

Can it be clarified the intent of the SNOMEDCT Code Depression Screening (procedure) 171207006?

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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      Thank you for your inquiry on CMS2v13: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Qualifying encounters are defined in the measure using this statement:
      Qualifying Encounter During Measurement Period
      ( ["Encounter, Performed": "Encounter to Screen for Depression"]
        union ["Encounter, Performed": "Physical Therapy Evaluation"]
        union ["Encounter, Performed": "Telephone Visits"] ) QualifyingEncounter
        where QualifyingEncounter.relevantPeriod during "Measurement Period"

      The qualifying encounter must be documented using a code included in "Encounter to Screen for Depression” (2.16.840.1.113883.3.600.1916), "Physical Therapy Evaluation" (2.16.840.1.113883.3.526.3.1022), or "Telephone Visits" (2.16.840.1.113883.3.464.1003.101.12.1080) value set. The eCQMs rely on the associated codes listed in the values on Value Set Authority Center (VSAC) to drive the measurement results. If one of the codes in the qualifying encounter value sets is documented, that meets the definition of a qualifying (eligible) encounter. Clinically equivalent services may be mapped to the codes used in a measure's value sets to satisfy the denominator requirement. We are unable to provide specific guidance related to the mapping of codes.

      We recommend you consult with your EHR vendor and clinical partners. If mapping is conducted, you should maintain documentation in case of a CMS audit.
      These value sets are located 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 set content contained in the eCQM specifications. The value sets are lists of unique coded identifiers with names (called descriptors) for groupings of clinical and administrative concepts selected from standard vocabularies.
      Show
      Thank you for your inquiry on CMS2v13: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. Qualifying encounters are defined in the measure using this statement: Qualifying Encounter During Measurement Period ( ["Encounter, Performed": "Encounter to Screen for Depression"]   union ["Encounter, Performed": "Physical Therapy Evaluation"]   union ["Encounter, Performed": "Telephone Visits"] ) QualifyingEncounter   where QualifyingEncounter.relevantPeriod during "Measurement Period" The qualifying encounter must be documented using a code included in "Encounter to Screen for Depression” (2.16.840.1.113883.3.600.1916), "Physical Therapy Evaluation" (2.16.840.1.113883.3.526.3.1022), or "Telephone Visits" (2.16.840.1.113883.3.464.1003.101.12.1080) value set. The eCQMs rely on the associated codes listed in the values on Value Set Authority Center (VSAC) to drive the measurement results. If one of the codes in the qualifying encounter value sets is documented, that meets the definition of a qualifying (eligible) encounter. Clinically equivalent services may be mapped to the codes used in a measure's value sets to satisfy the denominator requirement. We are unable to provide specific guidance related to the mapping of codes. We recommend you consult with your EHR vendor and clinical partners. If mapping is conducted, you should maintain documentation in case of a CMS audit. These value sets are located 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 set content contained in the eCQM specifications. The value sets are lists of unique coded identifiers with names (called descriptors) for groupings of clinical and administrative concepts selected from standard vocabularies.
    • CMS0002v14
    • CMS0002v13
    • If just the procedure of performing the screening can qualify a patient for the denominator and does not require any additional coding this can increase the number of patients being screened in the denominator.

      For the CMS2 measure, I am looking for clarification on the logic of the measure.

      There are three Encounters, Performed for this measure.

      Under the ["Encounter, Performed": "Encounter to Screen for Depression"] Value Set there are 106 CPT, HCPCS, and SNOMED CT codes. When I look at that list I see SNOMEDCT 171207006 is Depression screening (procedure).

      I then open up the Hierarchy Code Relationship and it includes depression screening using PHQ-2, PHQ-9 or Maternal postpartum depression screening.

      I am wondering if a patient is screened using the PHQ-2 or -9, does that need to be tied to any specific CPT, ICD or other type of billing code to be a qualifying encounter? Or even if the patient is screened using the PHQ-2 but the encounter has a CPT code of 99211 (as opposed to 99212 in the ["Encounter, Performed": "Encounter to Screen for Depression"] Value Set) should that encounter still count as a qualifying encounter for the numerator of the measure?

      Our EHR vendor has tied the SNOMEDCT 171207006 to the ICD-10 code "Z13.31 Encounter for screening for depression" and are claiming that we must have that ICD-10 code for the SNOMEDCT 171207006 code to count for the "Encounter, Performed". They are claiming that there is some other joiner or 'and' function that must be used to use that SNOMEDCT 171207006 "Encounter to Screen for Depression". Perhaps you can also clarify what is meant to occur for that SNOMEDCT "Encounter to Screen for Depression" to result in a positive function for patients to count in the denominator?

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            AIR EC eCQM Team AIR EC eCQM Team
            jeremypmorgan42 Jeremy Morgan
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              Created:
              Updated:
              Resolved: