Full Clinical Guidelines - Community First Health Plans.

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6.2 Behavioral <strong>Health</strong> Medical Record Review Tool 34 H EALTH PLANS www.cfhp.com
The evaluation of breast disease is based on risk factors and age and is determined by history, physical examination, imaging studies, cytologic examination, and biopsy. The clinician should be able to: • Obtain a history related to breast disorders including: • Duration, onset, and cyclicity of signs and symptoms • Menstrual and reproductive history • Hormone use • Dietary habits • Breast implants • Perform a thorough physical examination of the breasts • Educate patients on technique of breast self-examination • Counsel patients on the appropriate screening and diagnostic modalities for life-threatening breast disease, such as mammography and sonography, including timing and follow-up • Diagnose and manage (consistent with training and experience) or refer for management, patients with: • A solid or cystic breast mass • A mammographic abnormality • Breast pain • Physiologic and pathologic nipple discharge • Mastitis • Fibrocystic conditions • Counsel patients on familial risk and behavioral factors related to breast disease Thorough communication with patients about all management options, their risks, and all test results, as well as written documentation of these discussions, is of the utmost importance to the provision of quality care. Palpable Mass Cyst • Ultrasound or cyst aspiration useful to differentiate between solid and cystic mass. • With aspiration, if mass does not disappear or fluid is bloody, send for cytology and refer to surgeon. Fluid can otherwise by discarded. Re-examine breast in six weeks for recurrence. If cyst recurs refer to surgeon. Otherwise, follow routinely. Solid • Refer patient to surgeon for solid, dominant, persistent mass as biopsy is almost always indicated. • A normal mammogram does not eliminate need for further evaluation of a clinically suspicious mass. However, if mass is clinically benign on breast exam, and this is confirmed by cytologic exam and mammography, patient may be followed by a surgeon every three months until biopsy or resolution of problem. • Women
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CFHP has adopted the National Insti
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No CHD; 0 to 1, or 2+ Risk Factors
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NATIONAL CHOLESTEROL EDUCATION PROG
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NATIONAL CHOLESTEROL EDUCATION PROG
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Identification, Evaluation, and Tre
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11.3 Treatment of Hypertension H EA
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ALGORITHM FOR TREATMENT OF MAJOR DE
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A. Documentation ______ B. Continui
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CFHP PCP MEDICAL RECORD REVIEW TOOL
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Risk Factors for Osteoporosis Fract
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It is well documented that obesity
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CLASSIFICATION OF OVERWEIGHT AND OB
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16.1.1 Preventive Pediatric Health
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TEXAS MEDICAID PROVIDER PROCEDURES
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CHILDREN’S SERVICES HANDBOOK P h
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FIGURE 2: Recommended immunization
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Comprehensive antepartum care is vi
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The following variables should be e
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CRITERIA 19. Unresolved Problems Fr
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CFHP OB/GYN SPECIALTY MEDICAL RECOR
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According to the National Institute
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. aminotransferase (AST) and alanin
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PREVENTION RECOMMENDATIONS 1. The E
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2 to 20 years: Boys Body mass index
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AsthmaMatters is an initiative deve
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According to the Centers for Diseas
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