CMS 2/MIPS 134 - Preventive Care and Screening: Screening for Depression and Follow-Up Plan

What is this Measure?

Ensure that patients aged 12 years and older are screened for depression at least once annually using a standardized depression screening tool, and that appropriate follow-up is documented if the screening is positive.

Measure Goal:

The goal is to improve the early identification and management of depression, especially among adolescents and adults, by integrating mental health screening into routine care.

Populating the Denominator:

Patients over 12 years old with an eligible visit, and no prior depression or bipolar diagnosis:

Step 1: Open a Chart

Step 2: Open a Progress Note for the Patient

Step 3: Enter procedure code representing qualified encounter in the procedure section

Applicable Codes:

SNOMEDCT:
10197000, 108220007, 108221006, 108224003, 108311000, 13607009, 14736009, 165171009, 171207006, 18512000, 185349003, 185463005, 185465003, 252603000, 270427003, 270430005, 302440009, 308335008, 35025007, 370803007, 390906007, 406547006, 410155007, 410157004, 46662001, 53555003, 78318003, 83607001, 8411005, 86013001, 90526000        
CPT:
59400, 59510, 59610, 59618, 90791, 90792, 90832, 90834, 90837, 92625, 96105, 96110, 96112, 96116, 96125, 96136, 96138, 96156, 96158, 97165, 97166, 97167, 97802, 97803, 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, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99424, 99483, 99484, 99491, 99492, 99493        
HCPCS Level II:
G0101, G0270, G0271, G0402, G0438, G0439, G0444

Populating the Numerator:

Patients who were screened for depression using a standardized depression screening tool on the date of the encounter AND, if screening was positive, had a documented follow-up plan on the same date.

Recording the Screening if the result comes back Negative

If the result of the screening is negative, user must record the screening assessment using a LOINC in the procedure notes. The user must also record the negative depression screening result in the target site.

Depression Screening:

• LOINC: Adolescent depression screening assessment 73831-0

• LOINC: Adult Depression Screening 73832-8

Record Negative Finding:  

• Depression Screening Negative finding SNOMED: 428171000124102

Recording the Screening and Follow-Up if the result comes back Positive

If the result of the screening is positive, user must record the screening assessment using a LOINC in the procedure notes. The user must also record the positive depression screening result in the target site.

Depression Screening:

• LOINC: Adolescent depression screening assessment 73831-0

• LOINC: Adult Depression Screening 73832-8

Record Positive Finding:  

• Depression Screening Positive (Situation) SNOMED: 428181000124104

If the result of the screening comes back positive, the user must take steps for intervention. There are three ways a user could do this:

1. Record a current med

2. Record a Referral Order

3. Record an Intervention  

Recording a current med:

User can record a current med in the note which addresses the depression. This is done in the Current Medications section of the note.

• RXNORM
  1190110, 200371, 248642, 251201, 2591786, 2605950, 283406, 283407, 283485, 283672, 309313, 309314, 310384, 310385, 310386, 311725, 311726, 312938, 312940, 312941, 313580, 313581, 313582, 313583, 313584, 313585, 313586, 313989, 313990, 313995, 314111, 314277, 349332, 351249, 351250, 351285, 403969, 403970, 403971, 403972, 410584, 476809, 596926, 596930, 596934, 616402, 721787, 808744, 808748, 808751, 808753, 861064, 903873, 903879, 903884, 903887, 903891

Recording a referral for intervention:

User can record a SNOMED code which represents a referral to treat the depression. This is done in the Procedure Notes section of the note.

• SNOMEDCT
  1186918003, 1186920000, 183524004, 183528001, 183583007, 183866009, 306136006, 306138007, 306204008, 306226009, 306227000, 306252003, 308459004, 308477009, 390866009, 703978000, 710914003, 711281004

If There Is an Intervention Performed:

User can record an Intervention code. This is done in the Procedure Notes section of the note.

• SNOMEDCT
  108313002, 1555005, 15558000, 18512000, 228557008, 229065009, 28868002, 372067001, 385721005, 385724002, 385725001, 385726000, 385727009, 385887004, 385889001, 385890005, 386472008, 401277000, 405780009, 410223002, 410224008, 410225009, 410226005, 410227001, 410228006, 410229003, 410230008, 410231007, 410232000, 410233005, 410234004, 425604002, 439141002, 5694008, 75516001, 76168009, 76740001, 81294000, 88848003, 91310009

Important Note:

There are several ways to meet this Numerator!

• If the depression screening comes back negative - the result must be recorded

• If the depression screening comes back positive - the user must record:

• An intervention

• A referral

• A current med

• There are different codes for the Adolescent and Adult depression screening. Make sure the code used aligns with the patient’s age!

• Users must record the result of the depression screening associated to the LOINC (Positive or Negative)

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