This variable indicates whether a beneficiary met the condition criteria for major depressive affective disorder as of the end of the calendar year.
The condition variable requires beneficiaries to satisfy both claims criteria (a minimum number/type of Medicare claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (Medicare FFS Part A and Part B coverage during the entire specified time period).
For major depressive affective disorder, beneficiaries must have at least one Medicare inpatient claim or two other non-drug claims of any service type with a related code in any position during the 2-year reference period. When 2 claims are required, they must occur at least one day apart.
Note that this depressive affective disorder condition definition is slightly different than the CCW depression condition; this depressive affective disorder condition was specified by CMS to enhance research of the Medicare-Medicaid dually enrolled population. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories
Source: CCW (derived)
|0||Beneficiary did not meet claims criteria or have sufficient fee-for-service (FFS)
|1||Beneficiary met claims criteria but did not have sufficient FFS coverage|
|2||Beneficiary did not meet claims criteria but had sufficient FFS coverage|
|3||Beneficiary met claims criteria and had sufficient FFS coverage|