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Anti-depressant Medication Management

Last updated: May 9, 2019

CMS Measure ID: CMS128v8
Version: 8
NQF Number: Not Applicable
Measure Description:

Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported.

a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks).

b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).

Initial Population:

Patients 18 years of age and older who were dispensed antidepressant medications within 245 days (8 months) prior to the measurement period through the first 120 days (4 months) of the measurement period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event

Denominator Statement:

Equals Initial Populationinfo-icon

Denominator Exclusions:

Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date.

Exclude patients whose hospice care overlaps the measurement period.

Numerator Statement:

Numeratorinfo-icon 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment during the 114-day period following the Index Prescription Start Date.

Numerator 2: Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Previous Version:
Measure Scoring: Proportion
Measure Type: Process
Improvement Notation:

Higher score indicates better quality

Guidance:

To identify new treatment episodes for major depression, there must be a 105-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the first dispensing event associated with the Index Episode Start Date (Index Prescription Start Date).

Quality ID: 009
Meaningful Measure: Prevention and Treatment of Opioid and Substance Use Disorders

Specifications

Release Notes

Header

  • Updated eCQMinfo-icon version number.

    Measure Section: eCQM Version number

    Source of Change: Measure Lead

  • Updated NQFinfo-icon number to 'Not Applicable.'

    Measure Section: NQF Number

    Source of Change: Standards Update

  • Updated endorsed by field to 'None.'

    Measure Section: Endorsed By

    Source of Change: Standards Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated rationale.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated clinical recommendation statement.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references to align with American Psychological Association (APA) style.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated guidance statement with removal of cumulative medication duration as it was outdated.

    Measure Section: Guidance

    Source of Change: ONC Project Tracking System (JIRA)info-icon: CQMinfo-icon-3153

  • Updated guidance statement to reflect the 105 day negative medication history.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated initial populationinfo-icon statement dispensing event period to be from May 1 of the year prior to the measurement period to April 30 of the measurement period to align with HEDIS parent measure.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Updated initial population statement to require the visit to be in the 60 days before or after the initial patient population (IPP) antidepressant medication dispensing event.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Updated parenthetical citations to align with American Psychological Association (APA) style.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Revised logic of the 'Has Initial Major Depression Diagnosis' define statement to indicate the changed timing of the dispensed antidepressant in order to tie the clinician who could influence the medication choice and follow-up to the measure.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Revised logic to indicate the revised timing of the IPP dispensing event period to be from May 1 of the year prior to the measurement period to April 30 of the measurement period to align with HEDIS parent measure.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Revised the 'Qualifying Encounters' define statement to include nursing home encounters to expand those who can report the measure.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Changed the timing of the antidepressant relevant period to overlaps so that medications that are active in the 105 days prior may count as an exclusion as well as those started in the 105 days prior.

    Measure Section: Denominator Exclusionsinfo-icon

    Source of Change: Measure Lead

  • Updated the names of Clinical Quality Language (CQL)info-icon definitions, functions, and/or aliases for clarification and to align with CQL Style Guideinfo-icon.

    Measure Section: Definitions and Functions

    Source of Change: Standards Update

  • Updated Clinical Quality Language (CQL) expression to conform with the HL7info-icon Standard: Clinical Quality Language Specificationinfo-icon, Release 1 STUinfo-icon 3 (CQL 1.3).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated definitions and functions in the Measure Authoring Tool (MATinfo-icon) Global Common Functions Library to align with standards changes, Clinical Quality Language (CQL) Style Guide, and to include two new functions related to calculating hospital stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated version number of the Hospice Library (Hospice-2.0.000).

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-4.0.000).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

Value Setinfo-icon

The VSACinfo-icon is the source of truth for the value set content, please visit the VSAC for downloads of current value setsinfo-icon.

  • Value set Antidepressant Medication (2.16.840.1.113883.3.464.1003.196.12.1213): Added 34 RxNorm codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Annual Wellness Visit (2.16.840.1.113883.3.526.3.1240): Added SNOMED CT extensional value set (2.16.840.1.113883.3.526.2.1772) including 2 codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Psych Visit - Diagnostic Evaluation (2.16.840.1.113883.3.526.3.1492): Added SNOMED CT extensional value set (2.16.840.1.113883.3.526.2.1776) including 5 codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Psych Visit - Psychotherapy (2.16.840.1.113883.3.526.3.1496): Added SNOMED CT extensional value set (2.16.840.1.113883.3.526.2.1777) including 13 codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Major Depression (2.16.840.1.113883.3.464.1003.105.12.1007): Added 1 SNOMED CT code (16264901000119109) and deleted 4 SNOMED CT codes (268620009, 30605009, 321717001,70747007).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Added Nursing Facility Visit.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Direct reference code for Birth date (LOINC Code (21112-8)) now displayed in Human Readable.

    Measure Section: Terminology

    Source of Change: Annual Update

  • ​Removed code systeminfo-icon versions from direct reference codes. Please refer to Appendix A of the Electronic Clinical Quality Measureinfo-icon Logic and Implementation Guidance document for a list of code system versions used in the eCQM specificationsinfo-icon for 2020 reporting/performance.

    Measure Section: Terminology

    Source of Change: Standards Update

  • Standardized purpose statement language in value sets across eCQMsinfo-icon. Value set purpose statements are visible in the Value Set Authority Center (VSAC) as well as the downloadable eCQM value set files.

    Measure Section: Terminology

    Source of Change: Measure Lead

External Resources