2016 PQRS Measure #370: Depression Remission at Twelve Months

DESCRIPTION

Adult patients age 18 and older with major depression or dysthymia and an initial PHQ-9 score > 9 who demonstrate remission at twelve months defined as PHQ-9 score less than 5. This measure applies to both patients with newly diagnosed and existing depression whose current PHQ-9 score indicates a need for treatment

INSTRUCTIONS

This measure is to be reported once per reporting period for patients seen during the denominator identification measurement period with a diagnosis of depression and an initial PHQ-9 greater than nine. This measure may be reported by clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

NOTE: To be considered denominator eligible for this measure, the patient must have both the diagnosis of depression or dysthymia and an index date PHQ-9 Score greater than 9 documented during the dates of denominator identification measurement period (12/1/2014 to 11/30/2015.)

DENOMINATOR

Adults age 18 and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 score greater than nine during an outpatient encounter

Definition:
Index Date- The first instance (12/1/2014 to 11/30/2015) of elevated PHQ-9 greater than 9 and diagnosis of depression or dysthymia

AND
Diagnosis for MDD (ICD-10-CM): F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.9, F34.1
AND
Patient encounter during the reporting period (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0402, G0438, G0439
AND
Index Date PHQ-9 Score greater than 9 documented during the twelve month denominator identification period: G9511
AND NOT
Patients who died
OR
Patients who received hospice or palliative care service
OR
Patients who were permanent nursing home residents
OR
Patients with a diagnosis of bipolar disorder
OR
Patients with a diagnosis of personality disorder

NUMERATOR

Adults who achieved remission at twelve months as demonstrated by a twelve month (+/- 30 days) PHQ-9 score of less than five

Definitions:
Remission - a PHQ-9 score of less than five.
Twelve Months - the point in time from the index date extending out twelve months (+/- 30 days). The most recent PHQ-9 score within twelve months +/- 30 days (11 to 13 months after index) that is less than five is deemed as remission at twelve months. Scores obtained prior to or after this period are not counted as numerator compliant (remission).

Numerator Options:
Performance Met: Remission at twelve months as demonstrated by a twelve month (+/-30 days) PHQ-9 score of less than 5 (G9509)

OR
Performance Not Met: Remission at twelve months not demonstrated by a twelve month (+/-30 days) PHQ-9 score of less than five. Either PHQ-9 score was not assessed or is greater than or equal to 5 (G9510)
I want to compliment you and your colleagues for fine work.

Practice Administrator, Internal Medicine, Saint Augustine, FL

I've looked at all of them now and I'm convinced that yours is the best registry. So professional, so simple to use and backed by knowledgeable, personal support. I'm confident that I'll get PQRS reporting right!

Private Group Practice, Colorado

This is an intuitive interface that gathers just the info you need and nothing more. Whoever put it together had a good understanding of the info needed and how to set it up logically.

Physician, General Practice Network, Greensboro, NC

I recommended this solution to my colleagues and they're signing up too!

Physician Assistant, Family Care Group Practices, Chicago, IL

FYI, we did get a nice check from CMS (over $20,000!) so it is well worthwhile.

University of Pennsylvania

"I didn't know that I could have it any better. Somebody needs to let others know about all of the benefits of PQRSPRO!"

RN/Coder, Private Cardiology Practice

About 80% of our patient populate are Medicare, so CMS PQRS program incentives have been very lucrative for us.

RN/Coder, Private Cardiology Practice

We used a popular, more expensive PQRS Registry last year and had issues with the website but could not get anyone on the phone and had to leave voicemail and follow-up with an email.  For the money that we paid, they should have better customer service. PQRSPRO customer service is a Rolls Royce compared to the Volkswagen I experienced last year. When I called, I spoke to someone right away!

RN/Coder, Private Cardiology Practice

The PQRSPRO Registry system was easier to use than the other one.  Chart abstraction was simple and easy to understand and all measure questions were asked at once.  The other system made me wait for a prompt to move on once I answered one question – a much slower process.

RN/Coder, Private Cardiology Practice

The cost of PQRSPRO is much more reasonable than any other!

RN/Coder, Private Cardiology Practice

The final measure report was great and will also be useful for submitting to our malpractice insurance carrier to qualify for a discounted premium rate.

RN/Coder, Private Cardiology Practice

Users reported receiving up to $70,000 from participation in 2010 via our system.

President, Healthmonix

We are very happy with you and your company. Thank you for all of you efforts.

After trying for a couple years to receive the bonus, we finally received it this year using your system.

Your support has been awesome!

I wish we would've known about you three years ago! This was a breeze!

Group Cardiology Practice, Illinois

We are very satisfied with your process and service and confident that our practice will benefit from the incentive and avoid the penalties.

Intern, Ophthalmology Practice

Depression Remission at Twelve Months

CMS Disclaimer

If reporting for Physician Quality Reporting System (PQRS) through another Centers for Medicare and Medicaid Services’ (CMS) program (such as the Medicare Shared Savings Program, Comprehensive Primary Care Initiative, Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to earn a PQRS incentive and/or avoid the PQRS payment adjustment.

Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, eligible professionals (EPs) should look to the respective quality program to ensure they satisfy the PQRS, Electronic Health Record (EHR) Incentive Program, Value-based Payment Modifier (VM), etc. requirements of each of these programs.

You should not select that you participate in the Medicare PQRS-EHR Incentive Pilot when you attest to this question on the CMS website. The Healthmonix Registry is NOT a qualified submission vendor for clinical quality measures for purposes of meaningful use.