Depression Utilization of the PHQ-9 Tool

Last updated: July 12, 2017

CMS Measure ID: CMS160v4
Version: 4
NQF Number: 0712
Measure Description:

Adult patients age 18 and older with the diagnosis of major depression or dysthymia who have a PHQ-9 tool administered at least once during a 4-month period in which there was a qualifying visit.

Initial Patient Population:

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

Measure Population:

Not applicable

Measure Observations:

Not applicable

Denominator Statement:

Equals the 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:

Adult 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
Next Version: Depression Utilization of the PHQ-9 Tool
Previous Version: Depression Utilization of the PHQ-9 Tool
Measure Score: Proportion
Improvement Notation:

Higher scores indicate better quality

Guidance:

None

Specifications

Release Notes

Header

  • Added patients who received palliative care services to the Denominator Exclusions.
  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Reference updated.
  • eMeasure version number incremented from 4.1.000 to 4.2.000.

Logic

  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced the new timing operator 'overlaps' to replace two lines of logic (AND/AND NOT) or to enforce when an event or set of events occur to meet the measure intent.
  • Replaced 'ends before or during' (EBOD) with 'ends before end of' (EBE). As necessary, edited the associated number of (days, months, years) to maintain the same time period to accommodate the new timing operator.
  • Modified the upper bound timing in Population 2's Initial Population, Denominator Exclusions and Numerator from '> 4 month (s) starts after start of 'Measurement Period'' to '>= 4 month(s) start after start of 'Measurement Period'' to specify correctly this four-month period.
  • Replaced 'Measurement End Date' with 'Measurement Period' and as necessary replaced existing timing operator (e.g., replacing 'starts before start of' with 'starts before end of').
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • Replaced 'starts before or during' (SBOD) with 'starts before end of' (SBE).
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.

Value Sets

  • The new QDM element 'Patient Characteristic Expired' represents SNOMED code 419099009 (Dead). It replaces the previously used QDM  'Patient Characteristic Expired: Deceased' using 'Deceased Grouping Value Set (2.16.840.1.113883.3.67.1.101.11.721)'.
  • Value set Major Depression Including Remission (OID 2.16.840.113883.3.67.1.101.3.2444): Added 2 ICD9CM codes (298.0, 311).

XML

  • This measure contains multiple Population Criteria sections. The earlier version of this measure contained mismatches between the applicable Population Criteria human readable narrative sections and their associated computer-readable sections in the XML file. This issue has been corrected.

External Resources