Prenatal Depression Screening and Follow-Up (PND-E)

HEDIS Measure

Line of business: Commercial Medicaid

Data Collection Method:

Administrative (Claims)
Supplemental Data Submission

Standard - Electronic Clinical Data System (ECDS) Layout

Measure Description

The percentage of deliveries in which members were screened for clinical depression while pregnant and, if screened positive, received follow-up care.

Depression Screening. The percentage of deliveries in which members were screened for clinical depression during pregnancy using a standardized instrument.
Follow-Up on Positive Screen. The percentage of deliveries in which members received follow-up care within 30 days of a positive depression screen finding.

Numerator Compliance

Numerator 1—Depression Screening
Deliveries in which members had a documented result for depression screening, using an age appropriate standardized screening instrument, performed during pregnancy.

Deliveries between January 1 and December 1 of the measurement period: Screening should be performed between the pregnancy start date and the delivery date (including on the delivery date).
Deliveries between December 2 and December 31 of the measurement period: Screening should be performed between the pregnancy start date and December 1 of the measurement period.

Numerator 2—Follow-Up on Positive Screen
Deliveries in which members 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 condition.
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 dispensed antidepressant medication.
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.

Best Practices

Educate the patient about the importance of follow-up and adherence to treatment recommendations
Discuss the importance of timely, recommended follow-up visits
Schedule follow-up appointments as soon as possible, particularly those patients recently discharged
Coordinate care with behavioral health practitioners by sharing progress notes and updates
Outreach patients who cancel appointments and assist them with rescheduling as soon as possible
Consider telemedicine visit when in-person visits are not available
Discuss the importance of seeking follow-up with a mental health provider
Develop outreach internal team and/or assign care/case managers to members to ensure members keep follow-up appointments or reschedule missed appointments
Set flags if available in EHR or develop tracking method for patients who may need screenings and follow-up visits

Quality Value Set Directory Coding Tips

44261-6 Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]

The PHQ-9 is the standard (and most commonly used) depression measure, and it ranges from 0-27 Scoring: Add up all checked boxes on PHQ-9. For every check: Not at all = 0; Several days = 1; More than half the days = 2; Nearly every day = 3 (the scores are the codes that appear in the answer list for each of the PHQ-9 problem panel terms). Interpretation: 1-4 = Minimal depression; 5-9 = Mild depression; 10-14 = Moderate depression; 15-19 = Moderately severe depression; 20-27 = Severe depression.

55758-7 Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]

The PHQ-2 is the ultra-brief depression measure (using first 2 items of PHQ-9) and ranges from 0-6. Most who use the short PHQ-2 use it for screening and not for monitoring depression.

71354-5 Edinburgh Postnatal Depression Scale [EPDS]

The Edinburgh Postnatal Depression Scale (EPDS) was as a simple means of screening for postnatal depression in health care settings. It can also be used by researchers seeking information on factors that influence the emotional well-being of new mothers and their families. The EPDS is only a screening test and does not diagnose postpartum depression. Answers to the 10 questions are scored from 0-3, and then summed for a Total score. Higher scores indicate a greater risk of depressive illness and the need for more thorough evaluation by appropriate licensed health care provider.

71777-7 Total score [M3]

M3 Score is an algorithm to allow a person to take a self-test and receive a personalized score that shows: 1) an assessment of an individual's risk of suffering from any mood disorder, and 2) a patient on a clinical map showing if they have a low, medium or high risk for each of the following: Depression, Anxiety, Bipolar, PTSD.

71965-8 PROMIS-29 Depression score T-score

This score is calculated from question responses via coefficients. Valid range: 41.0 to 79.4.

89204-2 Patient Health Questionnaire-9: Modified for Teens total score [Reported.PHQ.Teen]

The Patient Health Questionnaire-9: Modified for Teens (PHQ-9 Teen) total score is the sum the first of 9 items (the answers to the other 4 items are used to assess the functional impairment due to depression and screen for dysthymia and suicide risk). These 9 items are scored from 0 to 3, with higher scores indicating more severe symptoms of depression.

89205-9 Center for Epidemiologic Studies Depression Scale-Revised total score [CESD-R]

The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) total score is the sum of the 20 item scores. Higher total scores indicate more severe depression, as evaluated by this instrument.

89208-3 Beck Depression Inventory Fast Screen total score [BDI]

The Beck Depression Inventory Fast Screen (BDI FS) total score is the sum of the 7 item scores. Higher total scores indicate more severe depression, as evaluated by this instrument.

89209-1 Beck Depression Inventory II total score [BDI]

The Beck Depression Inventory II total score is the sum of the 21 item scores. Higher total scores indicate more severe depression, as evaluated by this instrument.

90221-3 Total score [CUDOS]

The Clinically Useful Depression Outcome Scale (CUDOS) score correlates with the severity of depression with higher scores indicating more severe depression. A CUDOS total score ranging between 0-10 is considered non-depressed, 11-20 minimal depression, 21-30 is mild depression, 31-45 moderate depression, and 46 and above indicates severe depression.

90853-3 Final score [DUKE-AD]

The Duke Anxiety Depression Scale (DUKE-AD) final score is the sum of the 7 item scores, multiplied by 7.143. On a scale of 0 to 100, 0 indicates the lowest symptom level and 100 indicates the highest symptom level. Patients with scores above 30 are considered high risk for anxiety and/or depression.