2016 PQRS Measure #134: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

DESCRIPTION

Percentage of patients aged 12 years and older screened for clinical depression on 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 the positive screen

INSTRUCTIONS

This measure is to be reported a minimum of once per reporting period for patients seen during the reporting period. This measure may be reported by eligible professionals who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. The follow up plan must be related to a positive depression screening, example: “Patient referred for psychiatric evaluation due to positive depression screening”.

DENOMINATOR

All patients aged 12 years and older

AND
Patient encounter during the reporting period (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90839, 92625, 96116, 96118, 96150, 96151, 97003, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0101, G0402, G0438, G0439, G0444


NUMERATOR

Patients screened for clinical depression on the date of the encounter using an age appropriate standardized tool AND, if positive, a follow-up plan is documented on the date of the positive screen

Numerator Instructions: 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 in the office of the provider filing the code on the date of the encounter.

Definitions:
Screening – Completion of a clinical or diagnostic tool used to identify people at risk of developing or having a certain disease or condition, even in the absence of symptoms.
Standardized Depression Screening Tool – A normalized and validated depression screening tool developed for the patient population in which it is being utilized. The name of the age appropriate standardized depression screening tool utilized must be documented in the medical record.
Examples of depression screening tools include but are not limited to:
Adolescent Screening Tools (12-17 years)
Patient Health Questionnaire for Adolescents (PHQ-A), Beck Depression Inventory-Primary Care Version (BDI-PC), Mood Feeling Questionnaire (MFQ), Center for Epidemiologic Studies Depression Scale (CESD), and PRIME MD-PHQ2
Adult Screening Tools (18 years and older)
Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI or BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Depression Scale (DEPS), Duke Anxiety-Depression Scale (DADS), Geriatric Depression Scale (GDS), Cornell Scale Screening, and PRIME MD-PHQ2

Follow-Up Plan – Documented follow-up for a positive depression screening must include one or more of the following:
 Additional evaluation for depression
 Suicide Risk Assessment
 Referral to a practitioner who is qualified to diagnose and treat depression
 Pharmacological interventions
 Other interventions or follow-up for the diagnosis or treatment of depression

Not Eligible – A patient is not eligible if one or more of the following conditions are documented:
 Patient refuses to participate
 Patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient’s health status
 Situations where the patient’s functional capacity or motivation to improve may impact the accuracy of results of standardized depression assessment tools. For example: certain court appointed cases or cases of delirium
 Patient has an active diagnosis of Depression
 Patient has a diagnosed Bipolar Disorder

Numerator Quality-Data Coding Options for Reporting Satisfactorily:
Screening for Clinical Depression Documented as Positive, AND Follow-Up Plan Documented
(One quality-data code [G8431or G8510] is required on the claim form to submit this numerator option)
Performance Met: G8431: Screening for clinical depression is documented as being positive AND a follow-up plan is documented
OR
Screening for Clinical Depression Documented as Negative, Follow-Up Plan not Required
Performance Met: G8510: Screening for clinical depression is documented as negative, a follow-up plan is not required

OR
Screening for Clinical Depression not Documented, Patient not Eligible
(One quality-data code [G8433 or G8940] is required on the claim form to submit this numerator option)
Other Performance Exclusion: G8433: Screening for clinical depression not documented, documentation stating the patient is not eligible
OR
Screening for Clinical Depression Documented as Positive, Follow-Up Plan not Documented, Patient
not Eligible
Other Performance Exclusion: G8940: Screening for clinical depression documented as positive, a follow-up plan not documented, documentation stating the patient is not eligible

OR
Screening for Clinical Depression not Documented, Reason not Given
(One quality-data code [G8432 or G8511] is required on the claim form to submit this numerator option)
Performance Not Met: G8432: Clinical depression screening not documented, reason not given
OR
Screening for Clinical Depression Documented as Positive, Follow-Up Plan not Documented,
Reason not Given
Performance Not Met: G8511: Screening for clinical depression documented as positive, follow-up plan not documented, reason not given
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Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

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