Patients taking antipsychotic medications live with an increased risk of developing health conditions including diabetes, high blood pressure, abnormal cholesterol and triglyceride levels, and obesity. Given these risks, yearly screening and ongoing metabolic monitoring are integral to the management of antipsychotics for children, adolescents, and adults.
Whether you’re a primary care physician, behavioral health specialist, or prescriber, you can help ensure that patients taking antipsychotic medications are receiving annual screenings by ordering or conducting in-office point of care (POC) HbA1c or fasting glucose tests for diabetes, along with regular cholesterol monitoring.
Please be sure to use the following approved CPT codes when billing for screenings:
| Test | CPT Code |
| Glucose | 80047, 80048, 80050, 80053, 80069,
82947, 82950, 82951 |
| HbA1c | 83036, 83037 |
| LDL-C | 80061, 83700, 83701, 83704, 83721 |
| Cholesterol tests other than LDL | 82465, 83718, 84478, 83722 |
Additional recommendations for managing the care of patients taking antipsychotics are outlined on Point32Health’s Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) and Diabetes Screening for People with Schizophrenia or Bipolar Disorder who are Using Antipsychotic Medications (SSD) HEDIS Tip Sheets.
Coordinating care for a shared patient
Close collaboration among primary care providers, behavioral health specialists, and prescribers is crucial when treating patients who are taking antipsychotic medications. We encourage providers to use Point32Health’s Coordination of Care Check List — or a checklist of your own — to document and share provider contacts and communicate patient diagnoses, treatments, and other information beneficial to the development of an integrated care plan.
Care coordination resource for Tufts Health Together members
For Tufts Health Together members (18+) with Serious Mental Illness (SMI), keep in mind that our Behavioral Health (BH) Community Partners Program offers enhanced care coordination services including transitions of care support, health and wellness coaching, community resource assistance, and more. You can refer a patient to the program by forwarding their name, date of birth, ID number or MassHealth ID number, along with a short summary of the patient’s needs to [email protected].
At Point32Health, we appreciate your commitment to closing gaps in patient care and share your dedication to ensuring that members taking antipsychotic medications receive the continuum of care they need for improved overall health.
Annmarie Dadoly,
Senior Manager, Provider Communications
Joseph O’Riordan,
Editor
Susan Panos, Ellen Gustavson, Ryan Francis, Stephen Wong,
Writers
Kristin Edmonston,
Production Coordinator
Kristina Cicelova,
Graphic Designer