Correct billing + well child visits = prompt payments
By accurately billing for well child visits, you:
- Receive prompt payment for services rendered
- Reduce the number of charts needed for review at HEDIS time.
Document all components of the well child visits and bill us using current CPT coding guidelines. Please continue to provide well-child visits at 0–15 months (six visits), 3–6 years and 12–21 years (one visit/year). Maternal Infant Health Program and WIC visits do NOT substitute for well-child visits.
Thanks to you, developmental screenings for Priority Health Medicaid have improved!
| Measure | 2009 | 2010 |
|---|
| Use of code 96110 |
130 |
868 |
Please continue to perform developmental surveillance/screening as part of every well-child visit and refer for testing (codes 96110 and 96111) as needed. Children aged 0-36 months with positive screening results may be referred to Early On at 800 327-5966. Children ages 3+ should be referred to their local school district.
*Priority Health coverage — The preventive health exam includes a surveillance/screening exam for developmental disorders. If testing is required, testing isn’t considered a preventive benefit. For coverage details for testing/benefits, contact the Provider Helpline at 800 942-4765.
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