AdministrativeCommercialJanuary 1, 2022

Well-child visits: Know the numbers

Parents may not understand the importance of taking their children to the doctor when they are healthy. The benefits are documented by the American Academy of Pediatrics1 as well as the Centers for Disease Control and Prevention2 and it all starts with a recommendation by you, the trusted physician. Share these benefits with parents during regularly scheduled well-visits, or even during sick visits, to reinforce the importance of staying on track:

  • Prevention. Regular wellness visits ensure children receive scheduled immunizations that prevent illness. It is also a great opportunity to discuss nutrition and safety in the home.
  • Growth and development. Evaluating children for growth and development enables parents to see how much their children have grown since the last visit. It is also an opportunity to share the children’s development, to discuss milestones, social behaviors, and learning.
  • Raising concerns. Offering parents an opportunity to share concerns at the start of the visit will help in your evaluation of the patient. They may want to talk about development, sleep and eating habits and behaviors.
  • Team approach. Regular visits create strong, trustworthy relationships among physician, parent, and child. The American Academy of Pediatrics (AAP) supports well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental, and social health of a child.

 

Measure up: Well-Child Visits in the first 30 months of life (W30)

This HEDIS® measure is described as the percentage of members who had to the following number of well-child visits with a PCP during the last 15 months. These rates are reported:

  • Well-child visits in the first 15 months: Six or more well-child visits with children who turned age 15 months during the measurement year.
  • Well-child visits for ages 15 to 30 months: Two or more well-child visits with children who turned age 30 months during the measurement year.

 

Tips

  • Telehealth visits are acceptable in meeting the measurement requirements.
  • Consider scheduling well-child visits in advance of the child reaching the age for the visit.

 

Coding

  • ICD-10:110, Z00.111, Z00.121, Z00.129, Z00.2, Z00.3, Z02.5, Z76.1, Z76.2
  • HCPCS: G0438-G0439, S0302
  • CPT: 99381-99382, 99391-99392, 99461

 

1Parent Plus: Importance of routine pediatrician visits. American Academy of Pediatrics. https://publications.aap.org/aapnews/news/12481?autologincheck=redirected

2Catch up on well-child visits and recommended vaccinations. Centers for Disease Control and prevention. cdc.gov/vaccines/parents/visit/vaccination-during-COVID-19.html 

 

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