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Postpartum Visits

CMS Post-Partum Measure: https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-Measures/2020_Measure_336_MIPSCQM.pdf

DENOMINATOR: All patients, regardless of age, who gave birth during a 12-month period seen for postpartum care visit before or at 8 weeks of giving birth

Denominator Criteria (Eligible Cases): All patients, regardless of age AND Patient procedure during performance period (CPT): 59400, 59410, 59430, 59510, 59515, 59610, 59614, 59618, 59622 AND Postpartum care visit before or at 8 weeks post-delivery

NUMERATOR: Patients receiving the following at a postpartum visit:

• Breast-feeding evaluation and education, including patient-reported breast-feeding

• Postpartum depression screening

• Postpartum glucose screening for gestational diabetes patients

• Family and contraceptive planning counseling

• Tobacco use screening and cessation education

• Healthy lifestyle behavioral advice

• Immunization review and update

For PP Visit definitions: Refer to existing Data Dictionary

  • Consider methods to look for all visits not just PP coding

Contraceptive counseling and provision

Refer to existing Data Dictionary

Previous Resources

  1. /wiki/spaces/UCSF/pages/2090436077

  2. 2021-04-28 PP+Measure+Specification+Document_+Post-Partum+Followup+for+Contraception-EDIT.docx (sharepoint.com)

Diabetes screening for women with GDM-affected pregnancies

Refer to existing Data Dictionary

Previous Resources

  1. 2021-04-28 GDM+Measure+Specification+Document_+Post-partum+followup+for+gestational+diabetes_EDIT.docx (sharepoint.com)

Postpartum depression and anxiety screening, referral, and treatment

ACOG guideline: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/11/screening-for-perinatal-depression

HEDIS measure: https://www.ncqa.org/hedis/measures/postpartum-depression-screening-and-follow-up/

The percentage of deliveries in which members were screened for clinical depression during the postpartum period, and if screened positive, received follow-up care. Two rates are reported.

  1. Depression Screening: The percentage of deliveries in which members were screened for clinical depression using a standardized instrument during the postpartum period.

    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.

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“Appropriate screening at the comprehensive post-partum visit”

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Validated tools for screening?

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Patients with prior screening in pregnancy?

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High risk patients/SMI

  • SMI diagnosis codes?

  • Mood disorder diagnosis codes?

  • Prior history of PPMD

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Addressing PP anxiety/psychosis?

Emergent treatment: active SI, psychosis

...

https://www.samhsa.gov/find-help/national-helpline

Cardiovascular care (hypertensive disorders of pregnancy)

Substance use disorder screening, referral, and treatment

Other supporting evidence-based recommendations for postpartum care services

Breastfeeding Support:

CDC Guide to Strategies Supporting Breastfeeding: https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf

CMS Exclusive Breastfeeding: https://cmit.cms.gov/CMIT_public/ViewMeasure?MeasureId=2579

Tobacco use screening and cessation education:

  • Include tobacco screening?

  • Follow up recommendations/therapy?

Healthy lifestyle behavioral advice

  • Need to define?

Immunization review and update

HEDIS Prenatal immunization quality measure: https://www.ncqa.org/hedis/measures/prenatal-immunization-status/

...

Updated Measures will be located here when completed. Draft version is available here.

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