CommercialApril 1, 2021
Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services
To encourage well-visits and vaccinations, here are some extra steps you can take, if you haven’t already, to make visits as safe as possible for both patients and staff. They include:
- Scheduling sick visits and well-child visits during different times of the day.
- Asking patients to remain outside until it’s time for their appointment to reduce the number of people in waiting rooms.
- Offering sick visits and well-child visits in different locations.
It’s important to identify those children who have missed immunizations and well-child visits to schedule these essential in-person appointments. To help, the CDC has published vaccine catch-up guidance on their website.
Helpful information for keeping babies and children healthy
Childhood Immunization Schedule (CIS) HEDIS® measures require that all children are immunized by the age of two:
- Four DTaP (diphtheria, tetanus and acellular pertussis)
- Three IPV (polio)
- One MMR (measles, mumps, rubella)
- Three HiB (H influenza type B)
- Three HepB (hepatitis B)
- One VZV (chicken pox)
- Four PCV (pneumococcal conjugate)
- One HepA (hepatitis A)
- Two or Three RV (rotavirus)
- Two Influenza (flu)
Billing codes:
- MMR CPT: 90707, 90710 ICD-10-CM: B05.0-4, B05.81, B05.89, B05.9
- Mumps ICD-10-CM: B26.0-3, B26.81-85, B26.89, B26.9
- Rubella ICD-10-CM: B06.00-02, B06.09, B06.81-82, B06.89, B06.9
- Rubella CPT: 90706
- Rubella antibody CPT: 86762
- Hepatitis A (Hep A) CPT: 90633 ICD-10-CM: B15.0, B15.9
- Influenza CPT: 90655, 90657, 90661, 90662, 90673, 90685, 90686, 90687, 90688, 90689
- HCPCS: G0008
- Rotavirus vaccine (RV) CPT: 90681 (two-dose) and 90680 (three-dose)
Children should be fully immunized by 13 years of age to meet the Immunization for Adolescents (IMA) HEDIS® measure:
- 1 Meningococcal vaccine (MCV) injection between 11 to 13 years of age
- 1 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap/Td) between
10 to 13 years of age - 2 or 3 HPV vaccines between 9 to 13 years of age
Billing Codes:
- Meningococcal CPT: 90734
- Tdap CPT: 90715
- HPV CPT: 90649, 90650, 90651
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
For a complete list of HEDIS® measures, descriptions and coding tips, visit Anthem.com.
To view this article online:
Or scan this QR code with your phone