Treating behavioral health disorders in the primary care setting

When diagnosing an adult patient with depression and treating with an anti-depressant medication, it is very important to schedule at least three follow-up visits within the first 12 weeks of care. All visits should be coded with a depressive disorder diagnosis. In addition, good clinical practice includes monitoring your patients to ensure that your patients remain on their antidepressant medication for an appropriate length of time. Depression guidelines recommend an antidepressant trial of six months or longer if the patient is able to tolerate the medication. 
 
For children ages 6-12 who are prescribed an ADHD medication, it is recommended that a follow-up visit with the prescribing physician be scheduled within 30 days of medication initiation. The purpose of this visit is to assess the medication’s effectiveness and side effects. If the initial treatment response is positive, the medication trial should continue for at least 210 days (seven months), and at least two more follow-up visits with the prescriber should be scheduled within nine months.
 
Appropriate clinical practice includes screening adolescent and adult patients for alcohol and other drug dependence problems. Patients identified as having substance abuse problems should be scheduled for a follow-up visit (which must be coded with a substance abuse diagnosis on the claim) or a referral within 14 days of diagnosis.