CMS2v11 – Preventive Care and Screening: Screening for Depression and Follow-Up Plan

All patients aged 12 years and older at the beginning of the measurement period with at least one eligible encounter during the measurement period.

– DENOMINATOR EXCLUSION

Patients who have been diagnosed with depression or with bipolar disorder.

– DENOMINATOR EXCEPTIONS

• Patient refuses to participate.
• Documentation of medical reason for not screening patient for depression.

– NUMERATOR

Patients 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 tool AND if positive, a follow-up plan is documented on the date of the eligible encounter.

For Denominator: 

All patients aged 12 years and older with at least one eligible encounter during the measurement period are included in the denominator. To record an encounter, navigate to Patient > Provider Note > eSuperbill.

For Numerator:

Patients 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 tool. Patients satisfying any of the following conditions are included in the numerator:

1. Patient aged 12-16 years at the start of the measurement period screened for depression and if the result is positive, has a follow-up plan documented.

• To document negative result of the depression screening, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for adolescent depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening negative’. Then click ‘Sign’ or ‘Save’.

• To document positive depression screening result, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for adolescent depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening positive’. Then click ‘Sign’ or ‘Save’.
• The follow-up plan should be documented on the date of the positive screening for depression.
  • To order an intervention, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a referral intervention. From the ‘Status’ dropdown, select ‘Ordered’, then click ‘Sign’ or ‘Save’.
  • To document a follow-up provided during an encounter, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for an intervention. From the ‘Status’ dropdown, select ‘Performed’, then click ‘Sign’ or ‘Save’.
  • To order medication, navigate to Patient > Provider Notes > Prescriptions. Click ‘Add’ and search for the medication. Add the prescription details and then click ‘Prescribe’.

• Alternatively, users can fill out one of the assessment forms below to document the negative or positive depression screening result of a patient. Navigate to Patient > Clinical > Assessments.
  • PHQ-A (Patient Health Questionnaire-A)
  • MFQ (Mood Feelings Questionnaire)
  • PHQ-9 (Patient Health Questionnaire-9)
  • PHQ-2 (Patient Health Questionnaire-2)

Once the assessment form is complete, click ‘Save’. Depending on the score calculated, the patient is considered as screened positive or negative for depression.

2. Patient aged 17 years at the start of the measurement period screened for depression and if the result is positive, has a follow-up plan documented.

• To document negative result of the depression screening, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for an adolescent or adult depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening negative’. Then click ‘Sign’ or ‘Save’.
• To document positive depression screening result, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for an adolescent or adult depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening positive’. Then click ‘Sign’ or ‘Save’.
• The follow-up plan should be documented on the date of the positive screening for depression.
  • To order an intervention, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a referral for adolescent or adult depression. From the ‘Status’ dropdown, select ‘Ordered’, then click ‘Sign’ or ‘Save’.
  • To document a follow-up provided during an encounter, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a follow-up for adolescent or adult depression. From the ‘Status’ dropdown, select ‘Performed’, then click ‘Sign’ or ‘Save’.
  • To order medication, navigate to Patient > Provider Notes > Prescriptions. Click ‘Add’ and search for adolescent or adult depression medication. Add the prescription details and then click ‘Prescribe’.
• Alternatively, users can fill out one of the assessment forms below to document the negative or positive depression screening result of a patient. Navigate to Patient > Clinical > Assessments.
  • PHQ-A (Patient Health Questionnaire-A)
  • MFQ (Mood Feelings Questionnaire)
  • PHQ-9 (Patient Health Questionnaire-9)
  • PHQ-2 (Patient Health Questionnaire-2)

Once the assessment form is complete, click ‘Save’. Depending on the score calculated, the patient is considered as screened positive or negative for depression.

3. Patient aged 18 years or older at the start of the measurement period screened for depression and if the result is positive, has a follow-up plan documented.

• To document negative result of the depression screening, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for an adult depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening negative’. Then click ‘Sign’ or ‘Save’.

• To document positive depression screening result, navigate to Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for an adult depression screening. From the ‘Status’ dropdown, select ‘Performed’ and from the ‘Result’ dropdown, select ‘Depression screening positive’. Then click ‘Sign’ or ‘Save’.
• The follow-up plan should be documented on the date of the positive screening for depression.
  • To order an intervention, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a referral for adult depression. From the ‘Status’ dropdown, select ‘Ordered’, then click ‘Sign’ or ‘Save’.
  • To document a follow-up provided during an encounter, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a follow-up for adult depression. From the ‘Status’ dropdown, select ‘Performed’, then click ‘Sign’ or ‘Save’.
  • To order medication, navigate to Patient > Provider Notes > Prescriptions. Click ‘Add’ and search for adult depression medication. Add the prescription details and then click ‘Prescribe’.
• Alternatively, users can fill out one of the assessment forms below to document the negative or positive depression screening result of a patient. Navigate to Patient > Clinical > Assessments.
  • PHQ-9 (Patient Health Questionnaire-9)
  • GDS (Geriatric Depression Scale)
  • PHQ-2 (Patient Health Questionnaire-2)

Once the assessment form is complete, click ‘Save’. Depending on the score calculated, the patient is considered as screened positive or negative for depression.

For Denominator Exception:

Patient satisfying the following condition is part of the denominator exception.

• Adolescent/Adult Depression Screening not performed due to Patient Refusal. Also, the patient should not have an adolescent/adult depression screening record in the system prior to the qualifying encounter. To document this, navigate to Patient > Clinical > Evaluations to select a Patient Reason from dropdown.

• Adolescent/Adult Depression Screening not performed due to Medical Reason. Also, the patient should not have an adolescent/adult depression screening record in the system prior to the qualifying encounter. To document this, navigate to Patient > Clinical > Evaluations to select a Patient Reason from dropdown.

For Denominator Exclusion:

Patients with a diagnosis for depression or a diagnosis of bipolar disorder before the qualifying encounter. To add a diagnosis, use the workflow Patient < Clinical < Diagnosis.