Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)

The Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) HEDIS^® measure evaluates the percentage of children and adolescents 1 to 17 years of age who had two or more antipsychotic prescriptions and had metabolic testing. 

 

Antipsychotic medications can increase a child’s risk for developing health concerns, including metabolic health complications. The goal of this measure is for members to have metabolic monitoring by having both a blood glucose test (glucose or HbA1c) and LDL-C testing annually.

 

Record your efforts:

• Glucose test or HbA1c test and LDL-C cholesterol test as identified by claim/encounter
• Document results in the member’s medical record

 

Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
The Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) HEDIS measure evaluates members 18 to 64 years of age with schizophrenia, schizoaffective disorder or bipolar disorder, and who were dispensed an antipsychotic medication and had a diabetic screening test during the measurement year. 

 

Diabetes screening is important for anyone with schizophrenia or bipolar disorder. The added risk associated with antipsychotic medications contributes to the need to screen people with schizophrenia for diabetes annually.

 

Record your efforts:

• Glucose test or HbA1c test as identified by claim/encounter
• Document results in the member’s medical record

 

Helpful tips:

• Educate patients and their caregivers on the importance of completing blood work annually.
• If your practice uses electronic medical records (EMRs), have flags or reminders set in the system to alert when a patient is due for screenings.
• Draw labs in your office, if available, or refer members to a participating lab for screenings.
• Follow up on laboratory test results and document in your chart.
• Share EMR data with Anthem Blue Cross to capture all coded elements.

Other available resources:

• Clinical Practice Guidelines are available on our provider website at https://providers.anthem.com/ca.
• For The Quality Measures Desktop Reference for Medicaid Providers and HEDIS Benchmarks and Coding Guidelines for Quality Care, contact one of our Medi-Cal Customer Care Centers.

 

For more information, contact your local Provider Solutions representative, or call one of our Medi-Cal Customer Care Centers at 1-800-407-4627 (outside L.A.County) or 1-888-285-7801 (inside L.A. County).