Aug 1, 2021 • State & Federal / Medicaid

Well-child visits and vaccinations are essential services

In May 2020, the CDC released a report showing a drop in routine childhood vaccinations as a result of COVID-19; a result of stay-at-home orders and concerns about infection during well-child visits. Both the American Academy of Pediatrics and the CDC recommend the continuation of routine childhood vaccinations during the COVID-19 pandemic, noting they are essential services.



To encourage well-visits and vaccinations, here are some extra steps you can take to ensure visits are 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 is 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.

 

Help your patients earn rewards

For additional encouragement, Anthem Blue Cross and Blue Shield (Anthem) members can earn $25 or more in gift cards for completing vaccines and/or well visits through our Healthy Rewards program. Please encourage your patients to enroll in the program on the Anthem website so they can earn rewards for these activities. 

Anthem

CIS-3

IMA-2

WCV

Ages

0 to 1 (before 2nd birthday)

11 to 12 (before 13th birthday)

3 to 21

Reward amount

$25

$25

$25

 

Patients can enroll online at https://mss.anthem.com/ky or by calling 888-990-8681 (TTY 711).

 

Helpful information for keeping babies and children healthy:

Childhood Immunization Status (CIS) HEDIS® measure requires that all children are immunized by their 2nd birthday:

  • Four DTap (diphtheria, tetanus and acellular pertussis)
  • Three IPV (polio)
  • One MMR (measles, mumps, rubella)
  • Three HiB (H influenza type B)
  • Three Hep B (hepatitis B)
  • One VZV (chicken pox)
  • Four PCV (pneumococcal conjugate)
  • One Hep A (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:0-3, B26.81-85, B26.89, B26.9
  • Rubella:
    • ICD-10-CM:-00-02, B06.09, B06.81-82, B06.89, B06.9
  • Rubella antibody:
    • CPT: 86762
  • Hepatitis A:
    • CPT: 90633
    • ICD-10-CM:0, B15.9
  • Influenza:
    • CPT: 90655, 90657, 90662, 90673, 90685, 90686-90689
    • HCPCS: G0008
  • Rotavirus vaccine (RV):
    • CPT: 90681 (two-dose), 90680 (three-dose)

 

Children should be fully immunized by 13 years of age to meet the Immunization for Adolescents (IMA) HEDIS measure:

  • One meningococcal vaccine (MCV) injection between 11 and 13 years of age
  • One tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap/Td) between 10 and 13 years of age
  • Two or three HPV vaccines between 9 and 13 years of age

 

Billing codes:

  • Meningococcal:
    • CPT: 90734
  • Tdap:
    • CPT: 90715
  • HVP:
    • CPT: 90649, 90650, 90651

 

Please refer to the Anthem HEDIS coding booklet for coding guidelines.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

 

AKY-NU-0309-21


Featured In:
August 2021 Anthem Provider News - Kentucky