Are these acceptable referrals for CMS 134 Depression Screening for Depression and f/u Plans

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your inquiry on the Preventive Care and Screening: Screening for Depression and Follow-Up Plan eCQM. The measure’s Guidance section indicates the following: "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…” If the referrals below are specifically done to address depression, then you can work with your measure reporting vendor to map them to a code within the "Referral for Adolescent Depression” (2.16.840.1.113883.3.526.3.1570) or "Referral for Adult Depression” (2.16.840.1.113883.3.526.3.1571) value sets. Please review details on the referral with your healthcare providers, as "AMB REFERRAL TO SMHP PEDS CENTER FOR DEVELOPMENTAL MEDICINE” may be too general in the absence of explicit documentation that it is being ordered because of their depression score (e.g., this referral could be ordered for evaluation for autism or speech delays). The same is true for referral to "AMB REF TO MMP ORTHO SPORTS PSYCHOLOGY”.
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      Thank you for your inquiry on the Preventive Care and Screening: Screening for Depression and Follow-Up Plan eCQM. The measure’s Guidance section indicates the following: "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…” If the referrals below are specifically done to address depression, then you can work with your measure reporting vendor to map them to a code within the "Referral for Adolescent Depression” (2.16.840.1.113883.3.526.3.1570) or "Referral for Adult Depression” (2.16.840.1.113883.3.526.3.1571) value sets. Please review details on the referral with your healthcare providers, as "AMB REFERRAL TO SMHP PEDS CENTER FOR DEVELOPMENTAL MEDICINE” may be too general in the absence of explicit documentation that it is being ordered because of their depression score (e.g., this referral could be ordered for evaluation for autism or speech delays). The same is true for referral to "AMB REF TO MMP ORTHO SPORTS PSYCHOLOGY”.
    • CMS0002v15
    • CMS0002v14

      Would the following referrals meet the requirement for follow-up to a depression screening (CMS 134)?

      PROC_ID PROC_NAME PROC_CODE
      220061 AMB REF TO MMP ORTHO SPORTS PSYCHOLOGY REF220061
      10211258 AMB REFERRAL PED INTENSIVE HEALTH BEHAVIOR AND LIFESTYLE TX REF10041
      10299788 AMB REFERRAL TO BEHAVIORAL HEALTH INTEGRATION SERVICES REF850
      10314499 AMB REFERRAL TO DEVELOPMENTAL - BEHAVIORAL PEDIATRICS REF201001
      135 AMB REFERRAL TO NEUROPSYCHOLOGY REF47
      10299367 AMB REFERRAL TO PSYCHOLOGY REF776
      10258034 AMB REFERRAL TO SMHP PEDS CENTER FOR DEVELOPMENTAL MEDICINE REF61818

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Lynn Urbach
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