Well-Child Visits First 15 Months (W30A)
Line of business: BlueAlliance (Commercial)
Measure Description
The percentage of Members who had six or more well-child visits with a PCP (Primary Care Provider) on different dates of service on or before 15 months of age.
Notes
- Calculate the 15-month birthday as the child’s first birthday plus 90 days.
- The well-child visits 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.
Exclusions
- Members in hospice during the measurement year.
- Members 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.
- Make outreach calls and/or send letters to advise members of the need for a visit.
- Provide education during a sick visit regarding the importance of scheduling a well-child visit.
- Remind patients of their appointment by making calls or sending text messages.
- Promote signing up for echart if facility provides it (i.e., MyChart).
- Implement an appointment scheduler to come to the patient room to schedule next appointment.
- Schedule subsequent well-child visits at completion of current visit.
Well Care Codes
CPT® Codes | ||||
99381 | 99382 | 99391 | 99392 | 99461 |
HCPCS | ||
G0439 | G0438 | S0302 |
ICD-10 Codes | |||||
Z00.110 | Z00.111 | 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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