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Screening for Clinical Depression Initiative

August 29, 2017

Blue Cross and Blue Shield of New Mexico (BCBSNM) is committed to promoting annual screening and follow-up treatment for depression in the primary care setting for Blue Cross Community CentennialSM members. Although many patients may present to their primary care office with physical symptoms such as pain, poor sleep, or poor appetite, their comorbid diagnosis of depression often goes unrecognized. Primary care physicians may not have the tools or the time needed to screen or treat such patients. BCBSNM understands these challenges and wants to help.

Did you know?

  • Major Depressive Disorder (MDD) remains a treatable cause of pain, suffering, disability, and death.1
  • Primary Care Clinicians detect MDD in only one-third to one-half of their patients who meet diagnostic criteria for MDD and about one-half of those in which MDD is detected go untreated.2
  • Additionally, more than 80% of patients with depression have a medical comorbidity.3

What will you need and how will we help?

  • For Blue Cross Community Centennial members, BCBSNM reimburses providers for administering an annual depression screening tool using procedure code G0444 (administration). Results are reported simultaneously with either G8431 (positive screen with plan) or G8510 (negative screen) result code.
    • For dates of service July 1, 2017 through December 31, 2018 (or an earlier end-date as may be determined by HSD or BCBSNM), additional reimbursement will be provided for G8431 and G8510.
      • Add the modifier U8 in the modifier section on the CMS 1500 when submitting the claim that includes G0444 with the addition of either G8431 or G8510.
        • Any reimbursement will be made according to Blue Cross Community Centennial medical/reimbursement policies for services and other billing and reimbursement practices.
  • The PHQ-9 is completed by patients in your office and is easily accessible in multiple languages at www.phqscreeners.com Learn more about third-party links. The purpose of the PHQ-9 is to screen for depression.

Who should I screen?

  • Blue Cross Community Centennial patients who are 18 years of age and older
  • Blue Cross Community Centennial patients without an active diagnosis of depression, bipolar disorder or other mood symptoms

Patients who are not eligible for depression screening:

  • Patients who have had an annual depression screen or refuse to participate
  • Patients who are in an urgent or emergent situation where a delay in treatment may jeopardize the patient's health status
  • Patients whose functional capacity or motivation to improve may impact the accuracy of results (e.g., certain court-appointed cases or cases of delirium)
  • Patients who already have an active diagnosis of depression or bipolar disorder

To request additional assistance, you may contact your Provider Representative at BCBSNM or email Behavioral Health Quality Improvement at BHQualityImprovement@bcbstx.com.

1Williams Jr. JW, Noel PH, Cordes JA, et al. Is this patient clinically depressed? JAMA 2002;287:1160-70.
2Schonfeld WH, Verboncoeur CJ, Fifer SK, et al. The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder. J Affect Disord 1997;43:105-19.
3Klinkman MS. The role of algorithms in the detection and treatment of depression in primary care. JClin Psychiatry 2003;64[suppl 2]:19-23.