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.

See chart below:

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/wi 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).

 

AWI-NU-0272-21



Featured In:
June 2021 Anthem Provider News - Wisconsin