Managed Care Accountability Set (MCAS) Measure APM – Metabolic Monitoring for Children and Adolescents on Antipsychotics
| Date: | December 30, 2022 |
| To: | HPSJ Primary Care Providers, OBGYN, and Behavioral Health |
| From: | Health Plan of San Joaquin (HPSJ) |
| Type: | Informational/Educational |
| Subject: | Managed Care Accountability Set (MCAS) Measure APM – Metabolic Monitoring for Children and Adolescents on Antipsychotics |
| Business: | Medi-Cal Managed Care |
The following is a reminder regarding the MCAS Measure APM – Metabolic Monitoring for Children and Adolescents on Antipsychotics.
Measure Definition: Patients 1-17 years of age who had two or more antipsychotic prescriptions and had metabolic testing.
Coding your Claims and Encounters: APM is an admin measure and data can only be collected through claims and encounter data. It is important you ensure you have coded all your claims and encounters for your patients visit to the highest level of specificity.
| Code Type | Code | Definition |
|---|---|---|
| CPT | 82465, 83718, 83722, 84478 | Cholesterol Lab test |
| CPT | 80047, 80048, 80050, 80069, 82947, 82950, 82951 | Glucose Lab test |
| CPT | 83036, 83037 | HbA1c Lab test |
| CPT II | 3044F, 3045F, 3046F 3051F, 3052F | HbA1c Results |
| CPT | 80061, 83700, 83701, 83704, 83721 | LDL-C Lab Test |
| CPT II | 3048F, 3049F, 3050F | LDL-C Lab Test |
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared.