HEDIS® Tip Sheet

Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)

Line of business: BlueAlliance (Commercial) & BlueAlliance Care+ (Medicaid)

Measure Description

Percentage of Members 12 years of age and older who were screened for clinical depression using a standardized instrument and, if screened positive, received follow-up care.  

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

Compliance

  • Depression Screening: Members with a documented result for depression using an age-appropriate standardized instrument performed between January 1 and December 1 of the measurement period.
  • Follow-Up on Positive Screen: Members who received follow-up care within 30 days of a positive depression screen finding. 

Population

Members 12 years of age and older as of January 1.

Measurement Period

January 1 – December 31

Notes

Data for screening will come from supplemental data sources. Rates are reported in three age stratifications and a total rate.

  • 12-17 years
  • 18-64 years
  • 65+ years
  • Total Rate

The measure requires use of an age-appropriate screening instrument.  The patient’s age determines the screening instrument.

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.

Documentation Requirements

Name of the depression screening tool and result.

Screening Tools

The below screening tools use LOINC codes which require a corresponding result.



1Brief screening instrument. All other instruments are full-length.

2Proprietary; may be cost or licensing requirement associated with use.



1Brief screening instrument. All other instruments are full-length.

2Proprietary; may be cost or licensing requirement associated with use.

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Documented Follow-Up

  • Must occur on or up to 30 days after the first positive screen and may include:
    • Outpatient, phone, e-visit or virtual checking 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.
    • Diagnosis of encounter for exercise counseling (Z71.82).
    • A dispensed antidepressant medication.
  • OR
    • Documentation of additional depression screening on a full-length instrument indicating no depressive symptoms that require follow-up on the same day as a positive screen on a brief screening instrument.
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Exclusions

  • Members with a history of bipolar disorder any time during the member’s history through the end of the year prior to the measurement year.
  • Members with depression that starts during the year prior to the measurement year.
  • Members in hospice during the measurement year.
  • Members who die any time during the measurement period. 
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Best Practices

  • Use standardized clinical depression screening tools to screen patients and capture the scores and results at least annually.
  • For patients who have a history of depression, screen at each visit.
  • Screen new moms at their post-partum visit.
  • Utilize EMR reporting and patient flags for those in need of screening.
  • Schedule patients for follow-up visit at the time a positive screen is identified.
  • Educate patients on the importance of follow-up and adhering to treatment recommendations. 

Coding Disclaimer

The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.

Questions  

Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.

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