In May 2020, the Centers for Disease Control (CDC) released a report that showed 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, 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:

  • One meningococcal vaccine (MCV) injection between 11 to 13 years of age
  • One tetanus, diphtheria toxoids and acellular pertussis vaccine (TDAP/TD) between 10 to 13 years of age
  • Two or three 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.

 

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Featured In:
April 2021 Anthem Provider News - Wisconsin