Aetna considers certain services medically necessary for the assessment of attention deficit hyperactivity disorder ADHD:.
Psychological testing is not considered medically necessary for evaluation of children with uncomplicated cases of ADHD. In addition, neuropsychological or psychological testing performed solely for educational reasons may be excluded from coverage, as many Aetna benefit plans exclude coverage of educational testing; please check benefit plan descriptions. Neuropsychological testing may be medically necessary in neurologically complicated cases of ADHD e.
Referral to an outpatient mental health or chemical dependency provider may be medically necessary for the evaluation and comprehensive bio-psychosocial treatment for these disorders in collaboration with primary care physicians and other specialists. Usually, some symptoms that caused impairment were present before the age of 7 years. Some impairment from the symptoms is present in 2 or more settings e. Other causes of symptoms e. Attention deficit hyperactivity disorder ADHD is one of the most common neuro-behavioral disorders of childhood.
Approximately eight to ten Neba health fdating of school age children are diagnosed with ADHD, with males predominantly more affected than Examples include, but may not be limited to, anxiety disorder, conduct disorder, depression, oppositional defiant disorder and learning disabilities.
Although ADHD is usually diagnosed in childhood, it Neba health fdating last into adulthood. The behavior of individuals with ADHD may generally be classified into three subtypes; predominantly inattentive, predominately hyperactive-impulsive or a combination of the two.
ADHD is characterized by a pattern of behavior, present in multiple settings eg, school and homethat can result in performance issues in social, educational or work settings. There is no single test to diagnose ADHD. Typically, a diagnosis is made by a comprehensive exam that assesses the onset and course of symptoms consistent with ADHD. A functional assessment, if conducted, "Neba health fdating" both the severity of impairment and the pervasiveness of symptoms occurring in different environments.
There are several types of specialists qualified to diagnose and treat ADHD.
Examples include, but may not be limited to, child psychiatrists, family physicians, pediatricians, psychiatrists or neurologists. There is no specific test for ADHD; its diagnosis is a clinical Neba health fdating. It is used to rule out other psychiatric or environmental causes of symptoms.
A medical evaluation with a complete medical history and a physical examination is necessary. In general, attention-deficit disorders are best diagnosed through a careful history Neba health fdating the use of structured clinical interviews and dimensionally-based rating scales. Most psychologists obtain behavior ratings at home from the parents and at school from the teacher. Measurement of blood level of lead is appropriate only if clinical or environmental risk factors are present.
Electroencephalography or neurological consult is indicated only in the presence of focal signs or clinical suggestions of seizure disorder or degenerative condition. There are insufficient data to support the usefulness of computerized EEG brain mapping or neurometrics.
However, neuropsychological testing may be required in neurologically complicated cases of ADHD e. There are no data to support the use of hair analysis or measurement of zinc.
Medical management of ADHD entails the use of stimulants -- methylphenidate Neba health fdatingdextroamphetamine Dexedrinemethamphetamine Desoxynas well as an amphetamine-dextroamphetamine combination Adderall. Pemoline Cylert is restricted to secondary use because of hepatic dysfunction associated with its use.
Tricyclic anti-depressants are used for patients who "Neba health fdating" not respond to stimulants listed above, or for those who develop significant depression or other side effects on stimulants, or for the treatment of ADHD symptoms in patients with tics or Tourette's disorder.
The authors stated that more research into effectiveness and tolerability is urgentlu needed. Research into effectiveness and tolerability is urgently needed. The authors concluded that iron supplementation appeared to improve ADHD symptoms in children with low serum ferritin levels suggesting a need for future investigations with larger controlled trials.
Neuropsychological and psychological testing for purely educational reasons are not generally considered medically necessary. This testing is usually provided by school systems under applicable state and federal rules. Children with uncomplicated ADHD do not require neuropsychological or psychological testing. Attention deficit hyperactivity disorder is not an acquired disorder of adulthood. Adults who were never diagnosed as having ADHD in childhood may present with many of the "Neba health fdating" of the disorder.
Inattention and distractibility, impulsivity, as well as hyperactivity are the classic hallmarks of ADHD, but adult patients often lack the full symptom complex, especially hyperactivity. In this regard, adults with ADHD usually have a difficult time with activities that require passive waiting.
Adults with ADHD can be evaluated and successfully treated. Since the diagnosis is a clinical one, a comprehensive interview is the most important diagnostic procedure.
Childhood history is also extremely important Wender, Wender developed ADHD criteria, known as the Utah criteria, which reflect the distinct features of the disorder in adults Wender, In the absence of treatment, such symptoms "Neba health fdating" have been consistently present without remission.
The same medications used for children with ADHD are effective in adult patients.
This is in agreement with the findings from a meta-analysis Faraone et al, that the degree of efficacy of methylphenidate in treating ADHD adults is similar to what has been reported from meta-analyses of the child and adolescent literature. However, it should be noted that there is limited information Neba health fdating the long-term use of stimulants in adults Kooij et al, Many psychiatric and somatic symptoms are currently being treated with the help of neurofeedback.
In particular, neurofeedback is being used more and more to ADHD. Despite its growing popularity, neurofeedback is still a relatively unknown treatment method in psychiatric practices. They searched the "Neba health fdating" for reports on controlled trials that investigated the effectiveness of neurofeedback on ADHD.