Depression Screening and Follow-up for Adolescents and Adults

Date: 12/14/18

Depression is among the leading causes of disability in individuals ages 15 and older¹—follow up with patients who have positive screenings  

The U.S. Preventive Services Task Force (USPSTF) recommends screening for depressive disorder in adolescents between ages 12 and 18, and in the general adult population, including pregnant and postpartum women.

To ensure all our members are receiving the appropriate screening for depression, and timely follow-up, California Health & Wellness Plan (CHWP) monitors the National Committee on Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS^®) Depression Screening and Follow-Up (DSF) for Adolescents and Adults quality measure.

DSF MEASURE DESCRIPTION

DSF (previously named Clinical Depression Screening and Follow-Up) measures the percentage of patients ages 12 and older screened for clinical depression using an age-appropriate standardized depression screening tool and who, if screened positive, receive follow-up care. The patient must receive follow-up care within 30 days of screening positive for depression.

Examples of acceptable depression screening tools with thresholds for positive findings are listed in the table on page 3.

FOLLOW-UP

Documented follow-up for a patient screened as positive must include one or more of the following:

• Additional evaluation for depression on the same day and subsequent to the positive screen.
• Documentation of additional depression screening indicating either no depression or no symptoms that require follow-up (for example, if the PHQ-2 was used, documenting the PHQ-9 results to confirm negative or positive diagnosis).
• Follow-up with a behavioral health provider, including assessment, therapy, collaborative care, medication management, and acute care. Follow-up can be done with or without a telehealth modifier.
• Follow-up outpatient visit, with a diagnosis of depression or other behavioral health condition. This follow-up can be done with or without a telehealth modifier.
• Follow-up via a telephone visit. The visit must be documented with a diagnosis of depression or other behavioral health condition.
• Follow-up with a case manager, with documented assessment of depression symptoms or a diagnosis of depression or other behavioral health condition.
• Pharmacological interventions, such as dispensing an antidepressant medication.

¹ https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/depression-in-adults-screening1

A patient is not eligible for screening, if one or more of the following conditions are documented:

• Patient is diagnosed with depression during the prior calendar year.
• Patient has a diagnosed bipolar disorder during the calendar year or the year prior.
• Patient is in hospice or using hospice services during the calendar year.

ADDITIONAL INFORMATION

Providers are encouraged to access CHWP’s provider portal online at www.cahealthwellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact your Provider Relations representative or call 1-877-658-0305.