Last updated: May 3, 2018
| CMS Measure ID: | CMS159v5 |
|---|---|
| Version: | 5 |
| NQF Number: | 0710 |
| Measure Description: |
Patients age 18 and older with major depression or dysthymia and an initial Patient Health Questionnaire (PHQ-9) score greater than nine who demonstrate remission at twelve months (+/- 30 days after an index visit) defined as a PHQ-9 score less than five. This measure applies to both patients with newly diagnosed and existing depression whose current PHQ-9 score indicates a need for treatment. |
| Initial Patient Population: |
Patients age 18 and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 score greater than nine during the index visit |
| 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 achieved remission at twelve months as demonstrated by a twelve month (+/- 30 days grace period) PHQ-9 score of less than five |
| Numerator Exclusions: |
Not Applicable |
| Denominator Exceptions: |
None |
| Measure Steward: | MN Community Measurement |
| Domain: | Effective Clinical Care |
| Next Version: | |
| Previous Version: | |
| Improvement Notation: |
Higher score indicates better quality |
| Guidance: |
None |
| Quality ID: | 370 |
| High Priority Measure: | Yes |
| Data Submission Method: | CMS Web Interface,EHR,Registry |
| Specialty Measure Set: | Mental/Behavioral Health,General Practice/Family Medicine |
Specifications
CMS159v5_2.html
CMS159v5_2.xml- CMS159v5_SimpleXML_2.xml
EP_CMS159v5_NQF0710_Dep_Rem_12_2.zip
CMS159v5_TRN_04.01.16_0.xlsx
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
Updated the Definition statement to better reflect the measure intent.
Section: Definition
Source: Measure Lead
Simplified the Description statement by changing 'Adult patients' to 'Patients'.
Section: Description
Source: Measure Lead
The header Description did not indicate that remission at twelve months includes a grace period. Description updated to 'remission at twelve months (+/- 30 days) after an index visit'.
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
To better meet the measure intent, updated the Initial Population to reflect the patient age at the index encounter, rather than the age at the Measurement 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
To better meet the measure intent, updated the Initial Population to reflect the patient age at the index encounter, rather than the age at the Measurement Period.
Section: Initial Population
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: 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
Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.
Section: QDM Variables
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 Variables
Source: QDM Standards
To establish consistency across measures CMS159 and CMS160, updated the encounter timing logic in the $DepressionEncounter, $DepressionF2FSnomed and $DepressionEncounterBH variables from 'starts before start' and 'ends after start' to 'ends before start'. Also updated the corresponding numeric month timings to more accurately reflect the measure intent.
Section: QDM Variables
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: QDM Variables
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