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Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)

HEDIS Measure

Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)

Line of business: Commercial Medicaid

Data Collection Method: Administrative

Measure Description

The percentage of children and adolescents 1–17 years of age who had a new prescription for an antipsychotic medication and had documentation of psychosocial care as first-line treatment.

Numerator Compliance

Documentation of psychosocial care (Psychosocial Care Value Set) in the 121-day period from 90 days prior to the IPSD through 30 days after the IPSD.

IPSD - Index Prescription Start Date. The earliest prescription dispensing date for an antipsychotic medication where the date is in the Intake Period and there is a Negative Medication History.

Best Practices

  • Psychosocial care, such as behavioral interventions and psychological therapies, is the recommended first-line treatment option for children and adolescents diagnosed with nonpsychotic conditions such as attention-deficit disorder and disruptive behaviors
  • Periodically review the ongoing need for continued therapy with antipsychotic medications
  • Establish a baseline and continuously monitor metabolic indices to ensure appropriate management of side-effects of antipsychotic medication therapy
  • For new child/adolescent patients taking antipsychotics medications, complete a thorough evaluation and coordination with the mental health professional to ensure that all medications are addressing current symptoms for the patient's on going stability and recovery
  • Monitor children and adolescents prescribed antipsychotics closely as they are more at risk for serious health concerns, including weight gain, extrapyramidal side effects, hyperprolactinemia and some metabolic effects including glucose and cholesterol levels, as recommended by The American Academy of Child and Adolescent Psychiatry
  • Monitor female children/adolescents treated with certain antipsychotics closely as they may also be at increased risk for gynecological problems
  • Educate and inform parents/guardians of the increased side effect burden of multiple concurrent antipsychotics on children's health, which has implications for future physical health concerns including obesity and diabetes

Quality Value Set Directory Coding Tips

Psychosocial Care

CPT

  • 90832
  • 90833
  • 90834
  • 90836
  • 90837
  • 90838
  • 90839
  • 90840
  • 90845
  • 90846
  • 90847
  • 90849
  • 90853
  • 90875
  • 90876
  • 90880

HCPCS

  • G0176
  • G0177
  • G0409
  • G0410
  • G0411
  • H0004
  • H0035
  • H0036
  • H0037
  • H0038
  • H0039
  • H0040
  • H2000
  • H2001
  • H2011
  • H2012
  • H2013
  • H2014
  • H2017
  • H2018
  • H2019
  • H2020
  • S0201
  • S9480
  • S9484
  • S9485

SNOMED CT US Edition

  • 166001
  • 1555005
  • 2619005
  • 3518004
  • 5694008
  • 6227009
  • 7133001
  • 8411005
  • 9591001
  • 15142007
  • 15558000
  • 15711005
  • 17447008
  • 17914007
  • 18512000
  • 19997007
  • 21055002
  • 22900004
  • 24172008
  • 24621000
  • 25621005
  • 26693005
  • 26829003
  • 26890005
  • 27482005
  • 27591006
  • 28868002
  • 28988002
  • 30808008
  • 31408009
  • 31594000
  • 32051004
  • 33661004
  • 35358007
  • 36230009
  • 38592005
  • 38678006
  • 39697002
  • 41035007
  • 41653002
  • 41838008
  • 45565001
  • 46618005
  • 47805006
  • 50160009
  • 51484002
  • 51790004
  • 53508008
  • 53769000
  • 57070007
  • 57847003
  • 58771002
  • 59364003
  • 59585002
  • 59694001
  • 61436009
  • 62474003
  • 63386006
  • 65201004
  • 66060003
  • 73139001
  • 75516001
  • 76168009
  • 76740001
  • 77170008
  • 78493007
  • 79441000
  • 82309004
  • 83474000
  • 84892007
  • 85614001
  • 85925008
  • 88848003
  • 89909007
  • 90102008
  • 91172002
  • 91425008
  • 91481002
  • 108313002
  • 113141001
  • 113143003
  • 113144009
  • 171423009
  • 171424003
  • 171425002
  • 171426001
  • 183339004
  • 183381005
  • 183382003
  • 183383008
  • 183385001
  • 183387009
  • 183388004
  • 183389007
  • 183391004
  • 183393001
  • 183395008
  • 183396009
  • 183398005
  • 183399002
  • 183401008
  • 183402001
  • 183403006
  • 183405004
  • 183406003
  • 183408002
  • 183411001
  • 183413003
  • 183422002
  • 225160006
  • 225224008
  • 225225009
  • 225226005
  • 225227001
  • 225333008
  • 228546003
  • 228548002
  • 228549005
  • 228550005
  • 228551009
  • 228553007
  • 228554001
  • 228555000
  • 228557008
  • 228575009
  • 229216005
  • 229217001
  • 229218006
  • 229219003
  • 229220009
  • 229221008
  • 266744007
  • 299695005
  • 302230009
  • 302234000
  • 302235004
  • 302236003
  • 302238002
  • 302239005
  • 302240007
  • 302242004
  • 302243009
  • 302244003
  • 302245002
  • 302247005
  • 302248000
  • 302255003
  • 302259009
  • 302260004
  • 302262007
  • 304637004
  • 304638009
  • 304702006
  • 304814008
  • 304815009
  • 304816005
  • 304817001
  • 304818006
  • 304819003
  • 304820009
  • 304821008
  • 304822001
  • 304824000
  • 304825004
  • 304826003
  • 304851002
  • 304888004
  • 304889007
  • 304891004
  • 304892006
  • 304893001
  • 304894007
  • 311460008
  • 311461007
  • 311462000
  • 311510000
  • 311511001
  • 311522002
  • 311523007
  • 311884008
  • 312043006
  • 312044000
  • 313105004
  • 314034001
  • 361229007
  • 361230002
  • 385768000
  • 385769008
  • 385770009
  • 385771008
  • 385772001
  • 385773006
  • 385774000
  • 385893007
  • 385992003
  • 386255004
  • 386256003
  • 386257007
  • 386316003
  • 386367000
  • 386429002
  • 386522008
  • 386523003
  • 386524009
  • 386525005
  • 390773006
  • 391892008
  • 397074006
  • 401157001
  • 401162000
  • 405780009
  • 405792009
  • 405793004
  • 406165004
  • 406183007
  • 406184001
  • 406185000
  • 410112008
  • 410115005
  • 410118007
  • 410121009
  • 410124001
  • 410127008
  • 410130001
  • 425680009
  • 427954006
  • 429048003
  • 429159005
  • 429329005
  • 439330009
  • 439436002
  • 439741009
  • 439795004
  • 439805004
  • 439820005
  • 439916005
  • 440274001
  • 440582002
  • 440646003
  • 443119008
  • 443730003
  • 444175001
  • 449030000
  • 700445002
  • 700446001
  • 702471009
  • 702780005
  • 711078000
  • 712558003
  • 718023002
  • 718026005
  • 720444008
  • 723528003
  • 723619005
  • 734278000
  • 736861004
  • 866252000
  • 868185009
  • 460891000124103
  • 460901000124104
  • 461561000124103