Clinical practice guidelines list

The purpose of a clinical practice guideline is to help you engage your patients in discussions of goals, preferences and priorities, and to provide you with information on the most effective methods of screening, diagnosis and treatment.

Below is a list of all Priority Health-recommended Clinical Practice Guideline documents by topic. All originated from the Michigan Quality Improvement Consortium (MQIC) and have been adopted by Priority Health.  (MQIC) is a collaborative effort to develop and implement standard clinical guidelines and performance measures.  MQIC participants include physicians and other personnel representing the Michigan HMOs.  MAHP recognizes the expertise and evidence-based knowledge that the guidelines represent and encourages the use of accepted standards of care to promote quality care and better health outcomes for Michiganders.

Acute bronchitis

• Management of Uncomplicated Acute Bronchitis in Adults

Acute pharyngitis

• Acute Pharyngitis in Children (3 years and older) Adolescents and Adults

ADHD

• Diagnosis of Attention Deficit/Hyperactivity Disorder in Children and Adolescents
• Treatment of Attention Deficit/Hyperactivity Disorder in Children and Adolescents

Advance care planning

Alcohol and substance use

• Alcohol and Substance Use Disorder

Asthma

• General Principles for the Diagnosis and Management of Asthma

Back and neck pain

• Management of Acute Low Back Pain in Adults

Childhood overweight and obesity

• Prevention and Identification of Childhood Overweight and Obesity
• Treatment of Childhood Overweight and Obesity 

Deep venous thrombosis

• Outpatient Management of Uncomplicated Deep Venous Thrombosis

Depression

• Primary Care Diagnosis and Management of Adults with Depression

Diabetes

Heart failure

• Adults with Heart Failure with Reduced Ejection Fraction

Hypertension

• Medical Management of Adults with Hypertension

In-office sedation

• In-office Use of Sedation

Kidney disease

• Diagnosis and Management of Chronic Kidney Disease 
• Medicaid services available to help in early diagnosis of Chronic Kidney Disease (CKD) for your patients

Lipid management

• Lipid Screening and Management

Opioids

• Opioid Prescribing in Adults Excluding Palliative and End-of-Life Care
• Providers must be listed on the (Substance Abuse and Mental Health Services) SAMHSA administration website as certified.
• Claim must be billed with POS 58

Processing Medicare claims manual

40.1 - Place of Service (Rev. 4524 Issued; 02-14-20: Effective; 01-01-20: Implementation: 03-16-20)

Claims for OTP services should use Place of Service code 58 (Non-residential Opioid Treatment Facility - a location that provides treatment for OUD on an ambulatory basis. Services include methadone and other forms of MAT).

Resources

• Opioid Prescribing in Adults Excluding Palliative and End-of-Life Care
• CDC Guidelines for Prescribing Opioids for Chronic Pain
• Section II.G.: Medicare Coverage for Opioid Use Disorder (OUD) Treatment Services Furnished by Opioid Treatment Programs (OTPs)

Osteoporosis

• Management and Prevention of Osteoporosis

Osteoarthritis

Medical Management of Adults with Osteoarthritis

Overweight and obesity

• Management of Overweight and Obesity in the Adult

Pregnancy

• Prevention of Pregnancy in Adolescents 12-17 Years
• Prevention of Unintended Pregnancy in Adults 18 Years and Older
• Routine Prenatal and Post-natal Care

Preventive care

• Adult Preventive Services, ages 18-49
• Routine Preventive Services, ages 2-18
• Routine Preventive Services, ages birth - 24 months
• Adolescent and Young Adult Health Risk Behavior Assessment

Tobacco control