Well-Child Visits 15-30 Months (W30B)
Line of business: BlueAlliance (Commercial)
Measure Description
The percentage of Members who had two or more well-child visits with a PCP (Primary Care Provider) on different dates of service between the child’s 15-month birthday (plus 1 day) and the 30-month birthday.
Either of the following meet criteria:
- A well-care visit
- An encounter for well-care, do not include laboratory claims
Notes
- The age for this measure starts with the child’s 15-month birthday plus one day.
- The 30-month birthday is calculated as the child’s second birthday plus 180 days.
- The well-child visit must occur with a Primary Care Provider (PCP), but the PCP does not have to be the practitioner or provider assigned to the child.
- Well-Child visits must be at least 14 days apart to be counted.
- Telehealth visits do not count as well-child visits.
Exclusions
- Members in hospice during the measurement year.
- Member who died during the measurement year.
Best Practices
- Encourage parents to set up care with a PCP and educate parents on the importance of having preventive care visits.
- Educate parents on the importance of screening and counseling on healthcare topics done at each well-child visit.
- Educate parents on the importance of a well-child assessment
- Make outreach calls and/or send letters to advise members of the need for a visit.
- Remind parents of the upcoming appointment for their child by making calls, sending text messages or utilizing portal messaging.
- Promote signing up for patient portal if facility provides it (i.e., MyChart).
- Provide education on well-child visits or complete the well-child visit during a sick visit.
- Schedule subsequent well-child visits at completion of current visit. Consider implementing an appointment scheduler to come to the patient room.
- Distribute resources that provide the importance of well-child visits.
Well Care Codes
CPT® Codes | |||
99381 | 99382 | 99391 | 99392 |
HCPCS | ||
G0439 | G0438 | S0302 |
ICD-10 Codes | |||||
Z00.121 | Z00.129 | Z00.2 | Z76.2 | ||
Coding Disclaimer
The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.
Questions
Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.
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