DESCRIPTION:

Percentage of patients aged 12 years and older screened for 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

IMPROVEMENT NOTATION:

Higher score indicates better quality

INITIAL POPULATION:

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:

Equals Initial Population

DENOMINATOR EXCLUSIONS:

Patients with an active diagnosis for depression or a diagnosis of bipolar disorder

DENOMINATOR EXCEPTIONS:

Patient Reason(s): Patient refuses to participate

OR

Medical Reason(s): 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

OR

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

NUMERATOR:

Patients screened for 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 EXCLUSIONS:

Not Applicable


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.

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 (CES-D)

Patient Health Questionnaire (PHQ-9)

Pediatric Symptom Checklist (PSC-17)

PRIME MD-PHQ-2

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 for Depression in Dementia (CSDD)

PRIME MD-PHQ-2

Hamilton Rating Scale for Depression (HAM-D)

Quick Inventory of Depressive Symptomatology Self-Report (QID-SR)

Computerized Adaptive Testing Depression Inventory (CAT-DI)

Computerized Adaptive Diagnostic Screener (CAD-MDD)

Perinatal Screening Tools 

Edinburgh Postnatal Depression Scale

Postpartum Depression Screening Scale

Patient Health Questionnaire 9 (PHQ-9)

Beck Depression Inventory

Beck Depression Inventory–II

Center for Epidemiologic Studies Depression Scale

Zung Self-rating Depression Scale

Follow-Up Plan: Documented follow-up for a positive depression screening must include one or more of the following:

Additional evaluation or assessment 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


GUIDANCE: 

A depression screen is completed on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, either additional evaluation for depression, suicide risk assessment, referral to a practitioner who is qualified to diagnose and treat depression, pharmacological interventions, or other interventions or follow-up for the diagnosis or treatment of depression is documented on the date of the positive screen.

 

Depression screening is required once per measurement period, not at all encounters; this is patient based and not an encounter based measure.

Screening Tools:

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

The screening should occur during a qualified encounter 

Standardized depression screening tools should be normalized and validated for the age appropriate patient population in which they are used 

 

Follow-Up Plan:

The follow-up plan must be related to a positive depression screening, example: “Patient referred for psychiatric evaluation due to positive depression screening.”

Examples of a follow-up plan include but are not limited to: 

Additional evaluation or assessment for depression such as psychiatric interview, psychiatric evaluation, or assessment for bipolar disorder

Completion of any Suicide Risk Assessment such as Beck Depression Inventory or Beck Hopelessness Scale

Referral to a practitioner or program for further evaluation for depression, for example, referral to a psychiatrist, psychologist, social worker, mental health counselor, or other mental health service such as family or group therapy, support group, depression management program, or other            service for treatment of depression

Other interventions designed to treat depression such as psychotherapy, pharmacological interventions, or additional treatment options

Pharmacologic treatment for depression is often indicated during pregnancy and/or lactation. Review and discussion of the risks of untreated versus treated depression is advised. Consideration of each patient’s prior disease and treatment history, along with the risk profiles for individual pharmacologic agents, is important when selecting pharmacologic therapy with the greatest likelihood of treatment effect.