Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) is retired, only APM-E measure will be reported.

Product Lines:
EHP, Priority Partners and USFHP.

Eligible Population:
Members between 1 - 17 years of age as of December 31 of the measurement year.

Definition:
The percentage of members 1-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.

Three rates are reported (#3 is Accreditation for Commercial and Medicaid):

1. Percentage of children and adolescents on antipsychotics who received blood glucose testing.
2. Percentage of children and adolescents on antipsychotics who received cholesterol testing.
3. Percentage of children and adolescents on antipsychotics who received blood glucose and cholesterol testing.

Continuous Enrollment:

• The measurement year.

Best Practice and Measure Tips

• Members who received both of the following during the measurement year on the same or different dates of service: 
  • At least one test for blood glucose or HbA1c and at least one test for LDL-C or cholesterol.
  • If the medications are dispensed on different dates, even if it is the same medication, test both blood glucose with either a glucose or HbA1c test, and cholesterol with either a cholesterol or an LDL-C test.
  • Measure baseline lipid profiles, fasting blood glucose level and body mass index. 
• Ordering a blood glucose and cholesterol test every year and building care gap alerts in the electronic medical record. 
• Testing blood glucose and cholesterol at a member’s annual checkup or school physical to reduce additional visits.
• Educate members and caregivers about the:
  • Increased risk of metabolic health complications from antipsychotic medications.
  • Importance of screening blood glucose and cholesterol levels.
• Behavioral health providers:
  • Ordering blood glucose and cholesterol screening tests for members who do not have regular contact with their PCP and within 1 month of changing a member’s medication.

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year. 
• Members who died any time during the measurement year. 

Measure Codes

Need both an A1C or GLUCOSE and LDL-C or CHOLESTEROL.

• Blood Glucose 
  • HbA1C Lab Tests 
    • CPT: 83036, 83037 
    • CPT-CAT-II: 3044F, 3046F, 3051F, 3052F
    • LOINC: 17855-8, 17856-6, 4548-4, 4549-2, 96595-4
  • Glucose Lab Tests 
    • CPT: 80047, 80048, 80050, 80053, 80069, 82947, 82950, 82951 
    • LOINC: 10450-5, 1492-8, 1494-4, 1496-9, 1499-3, 1501-6, 1504-0, 1507-3, 1514-9, 1518-0, 1530-5, 1533-9, 1554-5, 1557-8, 1558-6, 17865-7, 20436-2, 20437-0, 20438-8, 20440-4, 2345-7, 26554-6, 41024-1, 49134-0, 6749-6, 9375-7
• Cholesterol 
  • LDL-C Lab Tests 
    • CPT: 80061, 83700, 83701, 83704, 83721
    • CPT-CAT-II: 3048F, 3049F, 3050F
    • LOINC: 12773-8, 13457-7, 18261-8, 18262-6, 2089-1, 49132-4, 55440-2, 96259-7
  • Cholesterol Lab Test
    • CPT: 82465, 83718, 83722, 84478 
    • LOINC: 2085-9, 2093-3, 2571-8, 3043-7, 9830-1

Measure Medications

Antipsychotic Medications Antipsychotic Combination Medications Prochlorperazine Medications