Description
Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
Guidance
The measure intends to screen for new cases of depression in patients who have never had a diagnosis of depression or bipolar disorder. Patients who have ever been diagnosed with depression or bipolar disorder prior to the qualifying encounter used to evaluate the numerator will be excluded from the measure regardless of whether the diagnosis is active or not.
A depression screen is completed on the date of the encounter or up to 14 calendar days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan must be documented on the date of or up to two calendar days after the date of the encounter, such as referral to a provider for additional evaluation, pharmacological interventions, or other interventions for the treatment of depression. An example to illustrate the follow-up plan documentation timing: if the encounter is on a Monday from 3-4 pm (day 0) and the patient screens positive, the clinician has through anytime on Wednesday (day 2) to complete follow-up plan documentation.
This measure does not require documentation of a specific score, just whether results of the normalized and validated depression screening tool used are considered positive or negative. Each standardized screening tool guides whether a particular score is considered positive for depression.
This eCQM is a patient-based measure. Depression screening is required once per measurement period, not at all encounters.
Screening Tools:
- An age-appropriate, standardized, and validated depression screening tool must be used for numerator compliance.
- The name of the age-appropriate standardized depression screening tool utilized must be documented in the medical record.
- The depression screening must be reviewed and addressed by the provider, filing the code, on the date of the encounter. Positive pre-screening results indicating a patient is at high risk for self-harm should receive more urgent intervention as determined by the provider practice.
- The screening should occur during a qualifying encounter or up to 14 calendar days prior to the date of the qualifying encounter.
- The measure assesses the most recent depression screening completed either during the qualifying encounter or within the 14 calendar days prior to that encounter. Therefore, a clinician would not be able to complete another screening at the time of the encounter to count towards a follow-up, because that would serve as the most recent screening. In order to satisfy the follow-up requirement for a patient screening positively, the eligible clinician would need to provide one of the aforementioned follow-up actions, which does not include the use of a standardized depression screening tool.
Follow-Up Plan:
The follow-up plan MUST still be provided for and discussed with the patient during the qualifying encounter used to evaluate the numerator. However, documentation of the follow-up plan can occur up to two calendar days after the qualifying encounter, per the policies of an eligible clinician or provider’s practice or health system. All services should be documented during, or as soon as practicable, after the qualifying encounter to maintain an accurate medical record.
The follow-up plan must be related to a positive depression screening, for example: "Patient referred for psychiatric evaluation due to positive depression screening".
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
Should a patient screen positive for depression, a clinician should:
- Only order pharmacological intervention when appropriate and after sufficient diagnostic evaluation. However, for the purposes of this measure, additional screening and assessment during the qualifying encounter will not qualify as a follow-up plan.
- Opt to complete a suicide risk assessment when appropriate and based on individual patient characteristics. However, for the purposes of this measure, a suicide risk assessment or additional screening using a standardized tool will not qualify as a follow-up plan.
This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Initial Population
All patients aged 12 years and older at the beginning of the measurement period with at least one qualifying encounter during the measurement period.
Date of birth information can be entered in DrChrono in the patient chart under the Demographics tab with the Patient's Date of Birth.
With A Qualifying Encounter During the Measurement Period
CPT Codes
59400, 59510, 59610, 59618, 90791, 90792, 90832, 90834, 90837, 92625, 96105, 96110, 96112, 96116, 96125, 96136, 96138, 96156, 96158, 97161, 97162, 97163, 97164, 97165, 97166, 97167, 98966, 98967, 98968, 99078, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99401, 99402, 99403, 99424, 99441, 99442, 99443, 99483, 99484, 99491, 99492, 99493, 99384,, 99385, 99386, 99387, 99394, 99395, 99396, 99397
HPCS Codes
G0101, G0402, G0438, G0439, G0444
CPT and HCPCS codes can be entered into the billing section for the encounter. Below is an example from the appointment window.
Denominator
Equals initial population.
Denominator Exclusions
Patients who have ever been diagnosed with depression or bipolar disorder at any time prior to the qualifying encounter.
Denominator Exceptions
Patient Reason(s) Patient refuses to participate
OR
Medical Reason(s)
Documentation of medical reason for not screening a patient for depression (e.g., cognitive, functional, or motivational limitations that may impact the accuracy of results; the patient is in an urgent or emergent situation where time is of the essence and delay treatment would jeopardize the patient's health status)
Numerator
Patients screened for depression on the date of the encounter or up to 14 days before the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
You can enter the LOINC codes for depression screening in the CQMs tab of the patient's chart under the Risk Category/Assessment section.
- Adolescent depression screening assessment LOINC Code 73831-0
- Adult depression screening assessment LOINC Code 73832-8
Click +New.
Enter the code or search for it. Select an appointment and click Create.
If the screening is positive, a follow-up plan needs to be documented. One area to document this is in the patient's chart in the CQMs tab under the intervention section.
You can enter or search for the code. Select ordered or performed and an appointment. Click Create when finished.
SNOMED Codes
| 108313002 | Family psychotherapy procedure (regime/therapy) |
| 1555005 | Brief group psychotherapy (regime/therapy) |
| 15558000 | Expressive psychotherapy (regime/therapy) |
| 18512000 | Individual psychotherapy (regime/therapy) |
| 228557008 | Cognitive and behavioral therapy (regime/therapy) |
| 229065009 | Exercise therapy (regime/therapy) |
| 28868002 | Interactive group medical psychotherapy (regime/therapy) |
| 372067001 | Implementation of measures to provide psychological support (regime/therapy) |
| 385721005 | Coping support assessment (procedure) |
| 385724002 | Coping support management (procedure) |
| 385725001 | Emotional support assessment (procedure) |
| 385726000 | Emotional support education (procedure) |
| 385727009 | Emotional support management (procedure) |
| 385887004 | Mental health history taking assessment (procedure) |
| 385889001 | Mental health history taking education (procedure) |
| 385890005 | Mental health history taking management (procedure) |
| 386472008 | Telephone consultation (procedure) |
| 401277000 | Completion of mental health crisis plan (procedure) |
| 405780009 | Dialectical behavior therapy (regime/therapy) |
| 410223002 | Mental health care assessment (procedure) |
| 410224008 | Mental health care education (procedure) |
| 410225009 | Mental health care management (procedure) |
| 410226005 | Mental health promotion assessment (procedure) |
| 410227001 | Mental health promotion education (procedure) |
| 410228006 | Mental health promotion management (procedure) |
| 410229003 | Mental health screening assessment (procedure) |
| 410230008 | Mental health screening education (procedure) |
| 410231007 | Mental health screening management (procedure) |
| 410232000 | Mental health treatment assessment (procedure) |
| 410233005 | Mental health treatment education (procedure) |
| 410234004 | Management of mental health treatment (procedure) |
| 425604002 | Case management follow up (procedure) |
| 439141002 | Discharge by mental health primary care worker (procedure) |
| 5694008 | Crisis intervention with follow-up (regime/therapy) |
| 75516001 | Psychotherapy (regime/therapy) |
| 76168009 | Group psychotherapy (regime/therapy) |
| 76740001 | Psychiatric telephone consultation or therapy with patient (procedure) |
| 81294000 | Patient referral for psychotherapy (procedure) |
| 88848003 | Psychiatric follow-up (procedure) |
| 91310009 | Patient follow-up to return when and if necessary (procedure) |
| 108313002 | Family psychotherapy procedure (regime/therapy) |
| 1555005 | Brief group psychotherapy (regime/therapy) |
| 15558000 | Expressive psychotherapy (regime/therapy) |
| 18512000 | Individual psychotherapy (regime/therapy) |
| 228557008 | Cognitive and behavioral therapy (regime/therapy) |
| 229065009 | Exercise therapy (regime/therapy) |
| 28868002 | Interactive group medical psychotherapy (regime/therapy) |
| 372067001 | Implementation of measures to provide psychological support (regime/therapy) |
| 385721005 | Coping support assessment (procedure) |
| 385724002 | Coping support management (procedure) |
| 385725001 | Emotional support assessment (procedure) |
| 385726000 | Emotional support education (procedure) |
| 385727009 | Emotional support management (procedure) |
| 385887004 | Mental health history taking assessment (procedure) |
| 385889001 | Mental health history taking education (procedure) |
| 385890005 | Mental health history taking management (procedure) |
| 386472008 | Telephone consultation (procedure) |
| 401277000 | Completion of mental health crisis plan (procedure) |
| 405780009 | Dialectical behavior therapy (regime/therapy) |
| 410223002 | Mental health care assessment (procedure) |
| 410224008 | Mental health care education (procedure) |
| 410225009 | Mental health care management (procedure) |
| 410226005 | Mental health promotion assessment (procedure) |
| 410227001 | Mental health promotion education (procedure) |
| 410228006 | Mental health promotion management (procedure) |
| 410229003 | Mental health screening assessment (procedure) |
| 410230008 | Mental health screening education (procedure) |
| 410231007 | Mental health screening management (procedure) |
| 410232000 | Mental health treatment assessment (procedure) |
| 410233005 | Mental health treatment education (procedure) |
| 410234004 | Management of mental health treatment (procedure) |
| 425604002 | Case management follow up (procedure) |
| 439141002 | Discharge by mental health primary care worker (procedure) |
| 5694008 | Crisis intervention with follow-up (regime/therapy) |
| 75516001 | Psychotherapy (regime/therapy) |
| 76168009 | Group psychotherapy (regime/therapy) |
| 76740001 | Psychiatric telephone consultation or therapy with patient (procedure) |
| 81294000 | Patient referral for psychotherapy (procedure) |
| 88848003 | Psychiatric follow-up (procedure) |
| 91310009 | Patient follow-up to return when and if necessary (procedure) |
| 183524004 | Referral to psychiatry service (procedure) |
| 183583007 | Refer to mental health worker (procedure) |
| 183866009 | Referral to emergency clinic (procedure) |
| 306136006 | Referral to liaison psychiatry service (procedure) |
| 306137002 | Referral to mental handicap psychiatry service (procedure) |
| 306226009 | Referral to mental health counseling service (procedure) |
| 306227000 | Referral for mental health counseling (procedure) |
| 306252003 | Referral to mental health counselor (procedure) |
| 306291008 | Referral to child and adolescent psychiatrist (procedure) |
| 306294000 | Referral to psychiatrist for mental handicap (procedure) |
| 308459004 | Referral to psychologist (procedure) |
| 308477009 | Referral to psychiatrist (procedure) |
| 309627007 | Child referral - clinical psychologist (procedure) |
| 390866009 | Referral to mental health team (procedure) |
| 703978000 | Referral to primary care service (procedure) |
| 710914003 | Referral to family therapy (procedure) |
| 711281004 | Referral to support group (procedure) |
| 183524004 | Referral to psychiatry service (procedure) |
| 183528001 | Referral to psychiatrist for the elderly mentally ill (procedure) |
| 183583007 | Refer to mental health worker (procedure) |
| 183866009 | Referral to emergency clinic (procedure) |
| 306136006 | Referral to liaison psychiatry service (procedure) |
| 306137002 | Referral to mental handicap psychiatry service (procedure) |
| 306138007 | Referral to psychogeriatric service (procedure) |
| 306204008 | Referral to psychogeriatric day hospital (procedure) |
| 306226009 | Referral to mental health counseling service (procedure) |
| 306227000 | Referral for mental health counseling (procedure) |
| 306252003 | Referral to mental health counselor (procedure) |
| 306294000 | Referral to psychiatrist for mental handicap (procedure) |
| 308459004 | Referral to psychologist (procedure) |
| 308477009 | Referral to psychiatrist (procedure) |
| 390866009 | Referral to mental health team (procedure) |
| 703978000 | Referral to primary care service (procedure) |
| 710914003 | Referral to family therapy (procedure) |
| 711281004 | Referral to support group (procedure) |
If you prescribe a medication for depression, it will be documented when you complete the prescription.
Medications can be prescribed in the patient's chart in the Send eRx tab.
Numerator Exclusions
Not applicable