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Prescribing Antipsychotic Medications? Monitor Patients with Care

Date: 05/29/24

Antipsychotic medications are effective in treating symptoms of certain mental health illnesses such as schizophrenia and bipolar disorder. They may also be prescribed for symptomatic relief for a range of other emotional problems. Despite benefits for many, antipsychotics may have significant side effects such as:

Considerable weight gain and obesity-related complications
Diabetes
Cardiovascular issues such as hypertension
Hypercholesterolemia
Movement disorders¹

It’s important to perform a metabolic baseline test and ongoing annual testing for all patients (children through adults) who take antipsychotic medications.

Metabolic testing must include both LDL-C and HbA1c annually.

CPT Codes:(Children**)	HbA1c Tests: 83036, 83037, 3044F, 3045F, 3046F, 3051F, 3052FGlucose Tests (other): 80047, 80048, 80050, 80053, 80069, 82947, 82950, 82951**LDL-C Tests: 80061, 83700, 83701, 83704, 83721, 83722, 3011F, 3048F, 3049F, 3050F
CPT Codes:(Adults)	HbA1c Tests: 83036, 83037, 3044F, 3045F, 3046F, 3051F, 3052FGlucose Tests (other): 80047, 80048, 80050, 80053, 80069, 82947, 82950, 82951LDL-C tests: 80061, 83700, 83701, 83704, 83721, 83722, 3011F, 3048F, 3049F, 3050F

Remember BEFORE Prescribing

Ensure patients have received a physical exam and been appropriately evaluated and diagnosed, and an alternative course of treatment does not exist.
Collaborate with and refer patients to mental health specialists/providers.
If intended as a short-term intervention, note the Stop Date, and schedule the follow-up.
Educate patients about possible side effects like weight gain, movement disorders, and other risks that must be monitored with regular blood tests.
Tell patients why it’s important to keep appointments with all treatment providers and for preventive health care.

Next Steps…Talk with your patient about:

How to take the medications, how they work, and expected benefits.
How long the patient should take them.
Why it’s important to keep taking medication even if the patient begins feeling better.
Scheduling appointments for continued monitoring and metabolic testing
Medication side effects they are experiencing.
What to do if they have questions or concerns and what to do if they are considering stopping the medication.

^1. Bostwick, J.R. & Murphy, L.R. (2017, May 29). Metabolic monitoring of antipsychotic medications: what psychiatrists need to know. https://www.psychiatrictimes.com/view/metabolic-monitoring-antipsychotic-medications-what-psychiatrists-need-know

This document is an informational resource designed to assist licensed healthcare practitioners in caring for their patients. Healthcare practitioners should use their professional judgment in using the information provided. HEDIS® measures are not a substitute for the care provided by licensed healthcare practitioners and patients are urged to consult with their healthcare practitioner for appropriate treatment. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).