| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Outcome | Yes | Effective Clinical Care | Mental/Behavioral Health |
Measure Description
Adult patients age 18 years and older with major depression or dysthymia and an initial PHQ-9 score > 9 who demonstrate remission at six months defined as a 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. This measure additionally promotes ongoing contact between the patient and provider as patients who do not have a follow-up PHQ-9 score at six months (+/- 30 days) are also included in the denominator
Instruction
This measure is to be reported once per performance 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 eligible 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 denominator identification measurement period dates of 12/1/2015 to 11/30/2016. Encounters in a Psychiatric, Behavioral, or Mental Health Setting require the diagnosis of depression or dysthymia to be a primary diagnosis.
Denominator
Adults age 18 and older with a diagnosis of major depression or dysthymia and an initial (index) PHQ-9 score greater than nine
Definition:
Index Date – The first instance (12/1/2015 to 11/30/2016) of elevated PHQ-9 greater than 9 and diagnosis of depression or dysthymia
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years
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 performance 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 identificat
AND NOT
DENOMINATOR EXCLUSIONS:
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 age 18 and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 score greater than nine who achieve remission at six months as demonstrated by a six month (+/- 30 days) PHQ-9 score of less than five
Definitions:
Remission – a PHQ-9 score less than five.
Six Months – the point in time from the index date extending out six months (+/- 30 days). Any PHQ-9 score less than five obtained during this two month period is deemed as remission at six months, values obtained prior to or after this period are not counted as numerator compliant (remission).
Numerator Options:
Performance Met: Remission at six months as demonstrated by a six month (+/-30 days) PHQ-9 score of less than five (G9573)
OR
Performance Not Met: Remission at six months not demonstrated by a six month (+/-30 days) PHQ-9 score of less than five. Either PHQ-9 score was not assessed or is greater than or equal to five (G9574)