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Practice Guidelines

Guideline Adoption and Recommended Use

PacificSource adopts guidelines to assist providers and members in making decisions about appropriate healthcare. Derived from nationally recognized sources, these guidelines are based on recent medical evidence and/or consensus among physicians regarding clinical treatment patterns. They are not intended to be a substitute for professional medical advice.

In all cases, benefit determinations should be based on the applicable contract coverage. Should there be any discrepency between these guidelines and the contract language, the contract language will take precedence.

Alcohol abuse screenings and references

Alcohol Use Disorders Identification Test (AUDIT) - Interview Form - PacificSource covers the use of this screening tool. Please use CPT code 99408.

Alcohol Use Disorders Identification Test (AUDIT) - Self-Report Form 

AUDIT: Guidelines for Use in Primary Care, Second Edition (PDF) - World Health Organization, Department of Mental Health and Substance Dependence

A Pocket Guide for Alcohol Screening and Brief Intervention - National Institute on Alcohol Abuse and Alcoholism, 2005

National Institute on Alcohol Abuse and Alcoholism (NIAA) Web site

American Psychiatric Association Practice Guideline for Substance Use Disorders, Second Edition - APA, May 2006

Alcohol Alert from the NIAAA: Publications -  National Institute on Alcohol Abuse and Alcoholism, 2005 

Helping Patients Who Drink Too Much: A Clinician’s Guide - National Institute on Alcohol Abuse and Alcoholism, 2005, updated in 2007

Behavioral health and chemical dependency

Practice Guidelines - American Psychiatric Association

Guidelines for Adolescent Depression in Primary Care (GLAD-PC) Toolkit - AHRQ Healthcare Innovations Exchange

Coronary artery disease

Third Report of the Expert Panel on Detection, Evaluation, and Treatment of the High Blood Cholesterol in Adults (Adult Treatment Panel III): Executive Summary - NHLBI, 2004

AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2006 Update - AHA, 2006

Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines  - AHA, 2004

Depression screening and references

American Psychiatric Association Practice Guidelines for Treatment of Patients with Major Depressive Disorder

The MacArthur Initiative on Depression and Primary Care Tool Kit

Patient Health Questionnaire (PHQ9) Overview

Diabetes

Diabetes Care 2010 Clinical Practice Recommendations- American Diabetes Association, 2010

Immunizations and screenings

Screening for Lipid Disorders in Adults – AHRQ, June 2008

Recommended Child & Adolescent Immunization Schedules Ages 0 to 6 - CDC, 2011

Recommended Child & Adolescent Immunization Schedules Ages 7 to 18 - CDC, 2011

Catch up schedule - CDC, 2011

Recommended Adult Immunization Schedule - CDC, 2011

Selected Preventive Screening Recommendations - CDC, 2010

Obesity: recommendations for children and adolescents

Identifying and preventing overweight in childhood. Clinical practice guideline – National Association of Pediatric Nurse Practitioners - AHRQ, 2006

Dietary Recommendations - October 4, 2010 American Heart Association

Active Healthy Living: Prevention of Childhood Obesity through Increased Physical Activity - American Academy of Pediatrics, 2006

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Last updated 5/25/2011