Thank you for your inquiry regarding CMS149v13 (Dementia: Cognitive Assessment). Because this is a patient-based measure, and since the measure determines whether the numerator requirements have been met based on the information in the patient’s EHR, then the screening performed by the Neurologist can be reported by both the Neurologist and the Primary if they both use the same EHR for the patient.   Additionally, the measure does include an exception if the cognitive assessment is not done for certain reasons. The value set “Patient Reason" includes codes that represent patient-specific reasons for not assessing cognition and are acceptable to use, if applicable, to document why the screening was not done. In the situation of a patient that has severe dementia and is unable to be given a cognitive test, SNOMEDCT codes such as 31021000119100 (Screening declined) or 275936005 (Patient noncompliance) may be appropriate.  

I am trying to find out, if a patient has been diagnosed with dementia, and the screening was performed by a Neurologist, can the Primary use that information for reporting, or does the screening have to be repeated? It doesn't make sense to put the patient through the screening twice, but if the Primary is working with the Neurologist, can they still report that the screening was performed? In addition, I would like to ask how we would handle a patient that has severe dementia, and is unable to be given a cognitive test or screening? That would be an exception, correct?