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
Diabetes screening for women with GDM-affected pregnancies
Refer to existing Data Dictionary
Previous Resources
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.
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.
“Appropriate screening at the comprehensive post-partum visit”
Validated tools for screening?
Edinburgh? (EDPS)-- short vs long
Other validated tools?
Patients with prior screening in pregnancy?
High risk patients/SMI
SMI diagnosis codes?
Mood disorder diagnosis codes?
Prior history of PPMD
Addressing PP anxiety/psychosis?
Emergent treatment: active SI, psychosis
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/
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommends influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccines for pregnant women to protect them and their infants from serious illness and death.