Depression Utilization of the PHQ-9 Tool

Last updated: January 31, 2017

CMS Measure ID: CMS160v5
Version: 5
NQF Number: 0712
Measure Description:

Patients age 18 and older with the diagnosis of major depression or dysthymia who have a Patient Health Questionnaire (PHQ-9) tool administered at least once during a 4-month period in which there was a qualifying visit

Initial Patient Population:

Patients age 18 and older with an office visit and the diagnosis of major depression or dysthymia during the four month period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

1: Patients who died

2: Patients who received hospice or palliative care services

3: Patients who were permanent nursing home residents

4: Patients with a diagnosis of bipolar disorder

5: Patients with a diagnosis of personality disorder

Numerator Statement:

Patients who have a PHQ-9 tool administered at least once during the four-month period

Numerator Exclusions:

Not applicable

Denominator Exceptions:

None

Measure Steward: MN Community Measurement
Domain: Effective Clinical Care
Previous Version: Depression Utilization of the PHQ-9 Tool
Improvement Notation:

Higher scores indicate better quality

Guidance:

None

Specifications

Release Notes

Header

  • Updated the Clinical Recommendation Statement to include all PHQ-9 questions.

    Section: Clinical Recommendation Statement

    Source: Measure Lead

  • Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • ​Simplified the Description statement by changing 'Adult patients' to 'Patients'.

    Section: Description

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • ​Simplified the Initial Population header statement by changing 'Adult patients' to 'Patients'.

    Section: Initial Population

    Source: Measure Lead

  • The Initial Population header statement referred to a diagnosis 'during each four month period'. Since a diagnosis will only meet the criteria for one four month period, clarified the statement by changing it to 'during the four month period'.

    Section: Initial Population

    Source: Measure Lead

  • ​Simplified the Numerator header statement by changing 'Adult patients' to 'Patients'.

    Section: Numerator

    Source: Measure Lead

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exclusions

    Source: QDM Standards

  • To better meet the measure intent and to establish consistency between measures CMS159 and CMS160, revised the Denominator Exclusions timing logic. Timing for 'Intervention, Order' and 'Encounter, Performed' has been updated to '<= 1 year(s) starts before end of Measurement Period'; timing for 'Expired' and 'Diagnoses' has been updated to 'starts before end of Measurement Period'.

    Section: Denominator Exclusions

    Source: Measure Lead

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Initial Population

    Source: QDM Standards

  • Replaced 'Diagnosis, Active: XXX (ordinality: Principal)' datatype with 'Encounter, Performed: XXX (principal diagnosis)' datatype to conform with QDM 4.2 changes and provide more accurate logic.

    Section: Initial Population

    Source: QDM Standards

  • To establish consistency across measures CMS159 and CMS160, updated the encounter timing logic in Initial Population 2 from 'starts after start' to 'ends after start'.

    Section: Initial Population

    Source: Measure Lead

  • Value set Face to Face Interaction - No ED (2.16.840.1.113762.1.4.1080.1): OID changed from 2.16.840.1.113762.1.4.1080.2 to 2.16.840.1.113762.1.4.1080.1.

    Section: Initial Population

    Source: None

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

  • Replaced 'Diagnosis, Active: XXX (ordinality: Principal)' datatype with 'Encounter, Performed: XXX (principal diagnosis)' datatype to conform with QDM 4.2 changes and provide more accurate logic.

    Section: QDM Data Elements

    Source: QDM Standards

  • Value set Face to Face Interaction - No ED (2.16.840.1.113762.1.4.1080.1): OID changed from 2.16.840.1.113762.1.4.1080.2 to 2.16.840.1.113762.1.4.1080.1.

    Section: QDM Data Elements

    Source: None

  • Value set Principal (2.16.840.1.113883.3.117.1.7.1.14): Removed Principal value set from measure.

    Section: QDM Data Elements

    Source: None

Value Set

  • Value set Face to Face Interaction - No ED (2.16.840.1.113762.1.4.1080.1): OID changed from 2.16.840.1.113762.1.4.1080.2 to 2.16.840.1.113762.1.4.1080.1.

    Section: None

    Source: None

  • Value set Major Depression (2.16.840.1.113762.1.4.1080.3): Created with 12 ICD9CM codes.

    Section: None

    Source: None

  • Value set Major Depression Including Remission (2.16.840.113883.3.67.1.101.3.2444): Added extensional value set Major Depression (2.16.840.1.113762.1.4.1080.3).

    Section: None

    Source: None

  • Value set Major Depression Including Remission (2.16.840.113883.3.67.1.101.3.2444): Deleted 2 ICD9CM codes (298.0, 311). Added 6 SNOMEDCT codes (251000119105, 281000119103, 321717001, 450714000, 191606003, 68019004).

    Section: None

    Source: None

  • Value set Personality Disorder (2.16.840.1.113883.3.67.1.101.1.246): Deleted 2 ICD10CM codes (F68.8, F69).

    Section: None

    Source: None

  • Value set Principal (2.16.840.1.113883.3.117.1.7.1.14): Removed Principal value set from measure.

    Section: None

    Source: None

External Resources