PDS-E - Postpartum Depression Screening and Follow-Up
Product Lines:
EHP, Priority Partners, and USFHP.
Measurement Period: January 1 - December 31
Description:
The percentage of deliveries in which persons were screened for clinical depression during the postpartum period, and if screened positive, received follow-up care.
- Depression Screening. The percentage of deliveries in which persons were screened for clinical depression using a standardized instrument during the postpartum period.
- Follow-Up on Positive Screen. The percentage of deliveries in which persons received follow-up care within 30 days of a positive depression screen finding.
Stratifications:
Report stratification by race and ethnicity.
Improvement Notation:
Increased score indicates improvement.
Data Collection:
- ECDS.
Initial Population:
- Measure Item Count: Episode.
- Age: None.
- Benefits: Medical.
- Continuous Enrollment: The delivery date through 60 days following the delivery date.
- Allowable Gap: None.
Denominator:
Denominator 1: Deliveries.
Deliveries in any setting, during September 8 of the year prior to the measurement period through September 7 of the measurement period.
Note: The measure is based on deliveries; therefore, it is possible for denominator to include multiple deliveries for the same person. Only the first eligible delivery in a 180-day period is included.
Denominator 2: All deliveries from numerator 1 with a positive finding for depression during the 7–84 days following the date of delivery.
Numerator:
Numerator 1: Depression Screening
Deliveries in which persons had a documented result for depression screening, using an age-appropriate standardized instrument, performed during the 7–84 days following the delivery date.
Numerator 2: Follow-Up on Positive Screen
Deliveries in which persons received follow-up care on or up to 30 days after the date of the first positive screen (31 total days).
Any of the following on or up to 30 days after the first positive screen:
- An outpatient, telephone, e-visit or virtual check-in follow-up visit with a diagnosis of depression or other behavioral health conditions.
- A depression case management encounter that documents assessment for symptoms of depression or a diagnosis of depression or other behavioral health condition.
- A behavioral health encounter, including assessment, therapy, collaborative care or medication management.
- A diagnosis of encounter for exercise counseling.
- A dispensed antidepressant medication.
OR
- Documentation of additional depression screening on a full-length instrument indicating either no depression or no symptoms that require follow-up (i.e., a negative screen) on the same day as a positive screen on a brief screening instrument.
Note: For example, if there is a positive screen resulting from a PHQ-2 score, documentation of a negative finding from a PHQ-9 performed on the same day qualifies as evidence of follow-up.
Depression Screening Instrument (Direct Reference Codes)
A standard assessment instrument that has been normalized and validated for the appropriate patient population. Eligible screening instruments with thresholds for positive findings include:
| Instruments for Adolescents (≤17 years) |
Total Score LOINC Codes |
Positive Finding |
|---|---|---|
| Patient Health Questionnaire (PHQ-9)® | 44261-6 | Total score ≥10 |
| Patient Health Questionnaire Modified for Teens (PHQ-9M)® | 89204-2 | Total score ≥10 |
| Patient Health Questionnaire-2 (PHQ-2)®1 | 55758-7 | Total score ≥3 |
| Beck Depression Inventory-Fast Screen (BDI-FS)®1,2 | 89208-3 | Total score ≥8 |
| Center for Epidemiologic Studies Depression Scale—Revised (CESD-R) | 89205-9 | Total score ≥17 |
| Edinburgh Postnatal Depression Scale (EPDS) | 99046-5 | Total score ≥10 |
| PROMIS Depression | 71965-8 | Total score (T Score) ≥60 |
1Brief screening instrument. All other instruments are full-length.
2Proprietary; may be cost or licensing requirement associated with use.
| Instruments for Adults (18+ years) | Total Score LOINC Codes |
Positive Finding |
|---|---|---|
| Patient Health Questionnaire (PHQ-9)® | 44261-6 | Total score ≥10 |
| Patient Health Questionnaire-2 (PHQ-2)®1 | 55758-7 | Total score ≥3 |
| Beck Depression Inventory-Fast Screen (BDI-FS)®1,2 | 89208-3 | Total score ≥8 |
| Beck Depression Inventory (BDI-II) | 89209-1 | Total score ≥20 |
| Center for Epidemiologic Studies Depression Scale—Revised (CESD-R) | 89205-9 | Total score ≥17 |
| Duke Anxiety-Depression Scale (DUKE-AD)®2 | 90853-3 | Total score ≥30 |
| Edinburgh Postnatal Depression Scale (EPDS) | 99046-5 | Total score ≥10 |
| PROMIS Depression | 71965-8 | Total score (T Score) ≥60 |
| Clinically Useful Depression Outcome Scale (CUDOS) | 90221-3 | Total score ≥31 |
1Brief screening instrument. All other instruments are full-length.
2Proprietary; may be cost or licensing requirement associated with use.
Best Practice and Measure Tips
- This measure requires the use of an age-appropriate screening instrument. The member’s age is used to select the appropriate depression screening instrument. If the correct age screening is not used, the member will not be compliant.
- Once the member is compliant for the screening, they will remain compliant for the screening element. For the intervention, the system is looking for the first positive screen date. Intervention compliance status is based on whether there is an intervention for the positive screening date. Only an earlier date of service with a different compliance can impact the compliance status for the follow-up.
- Documentation in a visit note must include the screening tool name, score, and date performed.
- The score should be clearly documented on the actual screening tool. The health plan cannot calculate the score.
- Depression screening captured in health risk assessments or other types of health assessments are allowed if the questions align with a specific instrument that is validated for depression screening. For example, if a health risk assessment includes questions from the PHQ-2, it counts as screening if the member answered the questions, and a total score is calculated.
- Implement postpartum depression screening calls within the first two weeks postpartum.
- Educate and provided educational material on signs and symptoms of postpartum depression.
- OASH Office on Women’s health have downloadable and printable resources Talking PPD: Campaign Toolkit
- Schedule a follow-up appointment after any positive assessments.
- Coordinate care with a behavioral health provider.
- Provide local community support resources and what to do in an event of a crisis.
- Document all treatment options discussed during the visit in the patient’s chart. When clinically appropriate, provide exercise counseling in addition to prescribing medication, and include diagnosis code Z71.82 to accurately capture this service. Comprehensive documentation supports accurate reporting and helps ensure the member meets compliance standards.
- Assess the need for Case Management and refer if necessary.
- The Johns Hopkins Health Plans Care Management team offers a variety of services to help members who are living with substance abuse and mental health issues may receive confidential care management support and coordination of care from a Licensed Clinical Social Worker. These behavioral health clinicians help members navigate their treatment needs for conditions such as depression, anxiety disorders, addictions, and autism spectrum disorders. For Priority Partners members, we work with Carelon Behavioral Health of Maryland to manage mental health needs.
- Please send us your member referrals by contacting us at:
Phone: 800-557-6916
Monday through Friday: 8 a.m. to 5 p.m.
Voicemail messages received after normal business hours will be addressed the following business day.
EHP Behavioral Health: 410-424-4891
EHP Behavioral Health- Secured: 410-424-4765
USFHP Mental Health: 410-424-4839
Advantage MD Behavioral Health, Inpatient & Outpatient: 844-340-2217
Email: [email protected]
- Please send us your member referrals by contacting us at:
- The Johns Hopkins Health Plans Care Management team offers a variety of services to help members who are living with substance abuse and mental health issues may receive confidential care management support and coordination of care from a Licensed Clinical Social Worker. These behavioral health clinicians help members navigate their treatment needs for conditions such as depression, anxiety disorders, addictions, and autism spectrum disorders. For Priority Partners members, we work with Carelon Behavioral Health of Maryland to manage mental health needs.
Measure Exclusions
Denominator Exclusions:
- Persons in hospice or using hospice services any time during the measurement period.
- Persons who died any time during the measurement period.
Measure Codes
Follow-up on Positive Screening
An outpatient, telephone, e-visit or virtual check-in follow-up visit
- CPT: 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98016, 98960, 98961, 98962, 98966, 98967, 98968, 98970, 98971, 98972, 98980, 98981, 99078, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99421, 99422, 99423, 99441, 99442, 99443, 99457, 99458, 99483
- HCPCS: G0071, G0463, G2010, G2012, G2250, G2251, G2252, T1015**
NOTE: **T1015 HCPCS code which identifies an all-inclusive clinic visit for services rendered at a Federally Qualified Health Center (FQHC) - SNOMED CT US Edition: 42137004, 50357006, 86013001, 90526000, 108220007, 108221006, 185317003, 185389009, 281036007, 314849005, 386472008, 386473003, 390906007, 401267002, 406547006, 870191006
- UBREV: 0510, 0513, 0516, 0517, 0519, 0520, 0521, 0522, 0523, 0526, 0527, 0528, 0529, 0982, 0983
A depression case management encounter
- CPT: 99366, 99492, 99493, 99494
- HCPCS: G0512, T1016, T1017, T2022, T2023
- SNOMED CT US Edition: 182832007, 225333008, 385828006, 386230005, 409022004, 410216003, 410219005, 410328009, 410335001, 410346003, 410347007, 410351009, 410352002, 410353007, 410354001, 410356004, 410360001, 410363004, 410364005, 410366007, 416341003, 416584001, 424490002, 425604002, 737850002, 1344983001, 1344984007, 1344994002, 1345003009, 1345013001, 1345014007, 621561000124106, 661051000124109, 662081000124106, 662541000124107, 842901000000108
Symptoms of Depression
- SNOMED CT: 394924000, 788976000
Depression or Other Behavioral Health Condition
- ICD-10-CM: F01.511, F01.518, F06.4, F10.180, F10.280, F10.980, F11.188, F11.288, F11.988, F12.180, F12.280, F12.980, F13.180, F13.280, F13.980, F14.180, F14.280, F14.980, F15.180, F15.280, F15.980, F16.180, F16.280, F16.980, F18.180, F18.280, F18.980, F19.180, F19.280, F19.980, F20.0, F20.1, F20.2, F20.3, F20.5, F20.81, F20.89, F20.9, F21, F22, F23, F24, F25.0, F25.1, F25.8, F25.9, F28, F29, F30.10, F30.11, F30.12, F30.13, F30.2, F30.3, F30.4, F30.8, F30.9, F31.0, F31.10, F31.11, F31.12, F31.13, F31.2, F31.30, F31.31, F31.32, F31.4, F31.5, F31.60, F31.61, F31.62, F31.63, F31.64, F31.70, F31.71, F31.72, F31.73, F31.74, F31.75, F31.76, F31.77, F31.78, F31.81, F31.89, F31.9, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.81, F32.89, F32.9, F32.A, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8, F33.9, F34.0, F34.1, F34.81, F34.89, F34.9, F39, F40.00, F40.01, F40.02, F40.10, F40.11, F40.210, F40.218, F40.220, F40.228, F40.230, F40.231, F40.232, F40.233, F40.240, F40.241, F40.242, F40.243, F40.248, F40.290, F40.291, F40.298, F40.8, F40.9, F41.0, F41.1, F41.3, F41.8, F41.9, F42.2, F42.3, F42.4, F42.8, F42.9, F43.0, F43.10, F43.11, F43.12, F43.20, F43.21, F43.22, F43.23, F43.24, F43.25, F43.29, F43.81, F43.89, F43.9, F44.89, F45.21, F51.5, F53.0, F53.1, F60.0, F60.1, F60.2, F60.3, F60.4, F60.5, F60.6, F60.7, F60.81, F60.89, F60.9, F63.0, F63.1, F63.2, F63.3, F63.81, F63.89, F63.9, F68.10, F68.11, F68.12, F68.13, F68.8, F68.A, F84.0, F84.2, F84.3, F84.5, F84.8, F84.9, F90.0, F90.1, F90.2, F90.8, F90.9, F91.0, F91.1, F91.2, F91.3, F91.8, F91.9, F93.0, F93.8, F93.9, F94.0, F94.1, F94.2, F94.8, F94.9, O90.6, O99.340, O99.341, O99.342, O99.343, O99.344, O99.345
- SNOMED CT US Edition: 109006, 162004, 281004, 600009, 832007, 899001, 1145003, 1196001, 1376001, 1380006, 1383008, 1499003, 1686006, 1816003, 1855002, 1973000, 2312009, 2403008, 2506003, 2618002, 2815001*
*Please note that not all SNOMED CT US Edition codes are listed here. For access to the complete set of codes related to PND-E measure, contact your Provider Engagement Liaison or email [email protected].
A behavioral health encounter, including assessment, therapy, collaborative care or medication management
- CPT: 90791, 90792, 90832, 90833, 90834, 90836, 90837, 90838, 90839, 90845, 90846, 90847, 90849, 90853, 90865, 90867, 90868, 90869, 90870, 90875, 90876, 90880, 90887, 99484, 99492, 99493
- HCPCS: G0155, G0176, G0177, G0409, G0410, G0411, G0511, G0512, H0002, H0004, H0031, H0034, H0035, H0036, H0037, H0039, H0040, H2000, H2001, H2010, H2011, H2012, H2013, H2014, H2015, H2016, H2017, H2018, H2019, H2020, S0201, S9480, S9484, S9485
- SNOMED CT US Edition: 5694008, 10197000, 10997001, 38756009, 45392008, 79094001, 88848003, 90407005, 91310009, 165171009, 165190001, 225337009, 370803007, 372067001, 385721005, 385724002, 385725001, 385726000, 385727009, 385887004, 385889001, 385890005, 401277000, 410223002, 410224008, 410225009, 410226005, 410227001, 410228006, 410229003, 410230008, 410231007, 410232000, 410233005, 410234004, 439141002
- UBREV: 0900, 0901, 0902, 0903, 0904, 0905, 0907, 0911, 0912, 0913, 0914, 0915, 0916, 0917, 0919
A diagnosis of encounter for exercise counseling
- ICD-10-CM code Z71.82
Measure Medication
Antidepressant Medications
- Amitriptyline
- Amitriptyline-chlordiazepoxide
- Amitriptyline-perphenazine
- Amoxapine
- Bupropion
- Citalopram
- Clomipramine
- Desipramine
- Desvenlafaxine
- Doxepin
- Duloxetine
- Escitalopram
- Fluoxetine
- Fluoxetine-olanzapine
- Fluvoxamine
- Imipramine
- Imipramine pamoate
- Isocarboxazid
- Levomilnacipran
- Maprotiline
- Mirtazapine
- Nefazodone
- Nortriptyline
- Paroxetine
- Paroxetine mesylate
- Phenelzine
- Protriptyline
- Selegiline
- Sertraline
- Tranylcypromine
- Trazodone
- Trimipramine
- Venlafaxine
- Vilazodone
- Vortioxetine