The Centers for Disease Control and Prevention (CDC) public sector vaccine ordering data shows a 14% drop in 2020 and 2021 compared to 2019, and measles vaccine is down by more than 20%. Children need to get caught up now, so they are protected as they get back to regular schedules, play times and prepare for summer camps. Healthcare providers can identify families whose children have missed doses and contact them to schedule appointments.1


Well-child visits

A well-child visit is an opportunity for parents to get regular updates about their child’s growth and development. For adolescents, it can be lifesaving, particularly when you discuss HPV, which isn’t always easy. The CDC has developed several resources for providers about how to recommend the HPV vaccine and how to talk to parents about the HPV vaccine. Get these resources from


Adults need preventive care, too

Getting good medical care that finds problems early and treats them effectively is an essential part of staying healthy. That’s why it is important for your adult patients to get those annual check-ups. It’s an opportunity for you to provide essential health services such as blood pressure, cholesterol and diabetes screenings. It is the perfect time to talk to your patients about their physical activity, their diet, and their overall wellbeing. Scheduling annual visits with your adult patients can lead to better health outcomes.


Measure Up


Adults’ Access to Preventive/ Ambulatory Health Services (AAP) HEDIS® measure includes members 20 years of age and older who have completed an ambulatory or preventive care visit during the measurement year.


Coding AAP

Ambulatory visit

CPT: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99483 HCPCS: G0402, G0438, G0439, G0463, T1015

ICD-10-CM: Z00.00, Z00.121, Z00.129, Z00.3, Z00.5, Z00.8, Z02.0, Z02.1, Z02.2, Z02.3, Z02.4, Z02.5, Z02.6, Z02.71, Z02.79, Z02.81, Z02.82, Z02.83, Z02.89, Z02.9, Z76.1, Z76.2

Other ambulatory visits

CPT: 92002, 92004, 92012, 92014, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

HCPCS: S0620, S0621

UBREV: 0524, 0525

Telephone visits

CPT: 98966, 98967, 98968, 99441, 99442, 99443

Online assessments

CPT: 98969, 98970, 98971, 98972, 98972, 99421, 99422, 99423, 99444, 99457, 99458 HCPCS: G0071, G2010, G2012, G2061, G2062, G2063


Child and Adolescent Well Care Visits (WCV) measures the percentage of members 3 to 21 years of age who had a least one comprehensive well-care visit with a PCP or an OB/GYN during the measurement year.


Coding WCV

This is an abbreviated list of codes associated with the WCV measure.


CPT: 99381-99385, 99391-99395, 99461

Encounter for routine child health check with abnormal findings

ICD-10: Z00.121

Encounter for routine child health check without abnormal findings

ICD-10: Z00.129 

Encounter for examination for period of rapid growth in childhood

ICD-10: Z00.2


Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of NCQA.




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April 2022 Anthem Provider News - Ohio