Description
Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
Download Template
Measure Template
Field | Description |
|---|---|
Provider NPI | 10-digit NPI number related to this instance |
Provider TIN * | 9-digit TIN number related to this instance |
Patient ID * | Patient identifier from source system |
First Name * | Patient first name, used for de-duplication |
Last Name * | Patient last name, used for de-duplication |
Gender * | Patient gender |
Date of service, YYYY/MM/DD * | Service date for this instance, must be within reporting year |
Patient date of birth, YYYY/MM/DD * | Patient birth date |
Payer | Primary insurance payer Suggested values are: “Medicare Part B FFS” or “Other” |
Encounter code * | CPT/HCPCS code for this instance |
Documentation stating the patient has had a diagnosis of bipolar disorder: G9717 (Must be true for the G9717 exclusion numerator) * | Must be TRUE if asserting G9717 numerator exclusion Otherwise, must be FALSE |
Measure 134 * | Numerator response code for this instance - see acceptable codes below |
* Indicates a mandatory field
Numerator Response Codes
The table below defines the acceptable numerator response codes for measure 134.
Numerator Code | Performance | Description |
|---|---|---|
G9717 | Exclusion | Not Eligible for Depression Screening or Follow-Up Plan |
G8431 | Met | Screening for depression is documented as being positive AND a follow-up plan is documented |
G8510 | Met | Screening for depression is documented as negative, a follow-up plan is not required |
G8433 | Exception | Screening for depression not completed, documented patient or medical reason |
G8432 | Not Met | Depression screening not documented, reason not given |
G8511 | Not Met | Screening for depression documented as positive, follow-up plan not documented, reason not given |