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  1. eCQM Issue Tracker
  2. CQM-7527

CMS 2 Follow-up Plan clarification

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Gregg Weinberg
    • 6462078848
    • Curana Health
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      Thank you for your inquiry regarding CMS2v14: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. If a patient has a positive depression screen, a follow-up plan must be documented on the date of or up to two days after the date of the qualifying encounter using any of the appropriate codes in the following value sets.
       
      "Intervention, Order: Referral for Adolescent Depression" using "Referral for Adolescent Depression (2.16.840.1.113883.3.526.3.1570)"
      "Intervention, Order: Referral for Adult Depression" using "Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571)"
      "Intervention, Performed: Follow Up for Adolescent Depression" using "Follow Up for Adolescent Depression (2.16.840.1.113883.3.526.3.1569)"
      "Intervention, Performed: Follow Up for Adult Depression" using "Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568)"

       The measure guidance states:
       
      Examples of a follow-up plan include but are not limited to:
       - Referral to a provider or program for further evaluation for depression, for example, referral to a psychiatrist, psychiatric nurse practitioner, psychologist, clinical social worker, mental health counselor, or other mental health service such as family or group therapy, support group, depression management program, or other service for treatment of depression
      - Other interventions designed to treat depression such as behavioral health evaluation, psychotherapy, pharmacological interventions, or additional treatment options
       
      If the example documentation for the follow-up plan you provided is mapped to coding provided in any of the above value sets and is clinically and technically appropriate, this would meet measure intent. For example, if the patient was referred to their primary care provider value for follow-up to obtain lab work, this could be mapped to SNOMEDCT 703978000: ‘Referral to primary care service’ within the "Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571)" value set and would meet the measure numerator requirement for follow-up. Also, if the patient received mental health care management to address certain environmental and/or social factors related to their positive depression screen, this could be mapped to SNOMEDCT 410225009: ‘Mental health care management’ within the “Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568)" value set, and this also would meet the numerator intent.
      Show
      Thank you for your inquiry regarding CMS2v14: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. If a patient has a positive depression screen, a follow-up plan must be documented on the date of or up to two days after the date of the qualifying encounter using any of the appropriate codes in the following value sets.   "Intervention, Order: Referral for Adolescent Depression" using "Referral for Adolescent Depression (2.16.840.1.113883.3.526.3.1570)" "Intervention, Order: Referral for Adult Depression" using "Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571)" "Intervention, Performed: Follow Up for Adolescent Depression" using "Follow Up for Adolescent Depression (2.16.840.1.113883.3.526.3.1569)" "Intervention, Performed: Follow Up for Adult Depression" using "Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568)"  The measure guidance states:   Examples of a follow-up plan include but are not limited to:  - Referral to a provider or program for further evaluation for depression, for example, referral to a psychiatrist, psychiatric nurse practitioner, psychologist, clinical social worker, mental health counselor, or other mental health service such as family or group therapy, support group, depression management program, or other service for treatment of depression - Other interventions designed to treat depression such as behavioral health evaluation, psychotherapy, pharmacological interventions, or additional treatment options   If the example documentation for the follow-up plan you provided is mapped to coding provided in any of the above value sets and is clinically and technically appropriate, this would meet measure intent. For example, if the patient was referred to their primary care provider value for follow-up to obtain lab work, this could be mapped to SNOMEDCT 703978000: ‘Referral to primary care service’ within the "Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571)" value set and would meet the measure numerator requirement for follow-up. Also, if the patient received mental health care management to address certain environmental and/or social factors related to their positive depression screen, this could be mapped to SNOMEDCT 410225009: ‘Mental health care management’ within the “Follow Up for Adult Depression (2.16.840.1.113883.3.526.3.1568)" value set, and this also would meet the numerator intent.
    • CMS0002v14
    • We are trying to better understand if there are interventions that constitute follow-up that are not encompassed by available SNOMED.

      We are trying to better understand if there are interventions that constitute follow-up that are not encompassed by available SNOMED.  

      For example, if a clinician believes that depressive symptoms are the result of a disease state e.g thyroid disease, can the plan be lab work to to confirm or rule out that hypothesis.

      Another example, the clinician believes that the addressing certain environmental and/or social factors would address mild depressive symptoms that are surfaced in positive depression screening.  How would those be captured by the existing code set?

            AIR EC eCQM Team AIR EC eCQM Team
            gsw8 Gregg Weinberg
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