PacificSource Community Solutions, PacificSource Medicare, and PacificSource Health Plans supports the use of practice guidelines that are based on nationally recognized, valid, and reliable evidence-based clinical literature or a consensus of professionals in a particular field. PacificSource adopts medical and behavioral health guidelines to assist providers and members in making decisions about appropriate healthcare choices. PacificSource practice guidelines are not meant to replace the clinical judgment of a treating provider. Guidelines are reviewed and updated as needed on an annual basis.
In all cases, benefit determinations should be based on the applicable contract coverage. Should there be any discrepancy between these guidelines and the contract language, the contract language will take precedence.
2018 GINA Report, Global Strategy for Asthma Management and Prevention - Global Initiative for Asthma, 2018
2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - American Heart Association, 2013
Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available from: http://goldcopd.org.
2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guidelines for the Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America, April 2017
Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents - American Academy of Pediatrics, 2011
Practice Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/ Hyperactivity Disorder, American Academy of Child and Adolescent Psychiatry, 2007
Alcohol Use Disorders Identification Test (AUDIT) - Interview Form (PDF) - PacificSource covers the use of this screening tool. Please use CPT code 99408.
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
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
Oregon Healthy Teens Survey - Questionnaire (8th & 11th grade versions) about alcohol, drug and nicotine use.
AACAP Practice Parameters, American Academy of Child and Adolescent Psychiatry (AACAP), 2015
The American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-Related Disorders, (Second Edition – Revised): (ASAM PPC-2R), 2001
Screening for Depression in Adults - AHRQ, Agency for Healthcare Research and Quality, April 2013
Guidelines for Adolescent Depression in Primary Care (GLAD-PC) Toolkit - Version 2, 2010, The Research Institute
Beck Depression Inventory, Beck, A.T, 1979