Depression Remission at Twelve Months

Last updated: May 17, 2016

CMS Measure ID: CMS159v4
Version: 4
NQF Number: 0710
Measure Description:

Adult patients age 18 and older with major depression or dysthymia and an initial PHQ-9 score > 9 who demonstrate remission at twelve months defined as PHQ-9 score less than 5. 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:

Adults age 18 and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 score greater than nine during an outpatient encounter.

Denominator Statement:

Equals the Initial Patient 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:

Adults who achieved remission at twelve months as demonstrated by a twelve month (+/- 30 days) PHQ-9 score of less than five.

Numerator Exclusions:

None

Denominator Exceptions:

None

Measure Steward: MN Community Measurement
National Quality Strategy Domain: Effective Clinical Care
Next Version: Depression Remission at Twelve Months
Previous Version: Depression Remission at Twelve Months
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality

Guidance:

None

Specifications

Release Notes

Header

  • Copyright updated.
  • eMeasure version number incremented.
  • Patients who received palliative care services have been added to the Denominator Exclusions.
  • Reference updated.

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.
  • Introduced variables $DepressionIndex, $DepressionF2FSnomed, $DepressionEncounterBH and $DepressionEncounter to enforce that the same instance of a clinical event is used throughout the measure when the logic within the variable does not limit the event to a single instance, e.g., FIRST or MOST RECENT.
  • 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 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)'.
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.

Value Sets

  • Value set Major Depression Including Remission (OID 2.16.840.113883.3.67.1.101.3.2444): Added 2 ICD9CM codes (298.0, 311).

External Resources