Posted in Training, Updates

HEDIS Measure: Well-child visits in first 30 months.

Bringing young children to see the primary care physician, for a well-care visit is extremely important.


These visits track:

Prevention: 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.


Description of the measure:

Describes the percentage of members who had to the following number of well-child visits with a PCP during the last 15 months.

The rates are reported as follows:

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.


In order to receive credit for this measure the following DX should be used:

  • ICD-10:110, Z00.111, Z00.121, Z00.129, Z00.2, Z00.3, Z02.5, Z76.1, Z76.2

The following CPT codes should be used:

  • CPT: 99381-99382, 99391-99392, 99461

The following HCPCS should be used:

  • HCPCS: G0438-G0439, S0302

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Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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