Iowa Early Periodic Screening, Diagnosis and Treatment Care for Kids Program Provider Training

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1 Iwa Early Peridic Screening, Diagnsis and Treatment Care fr Kids Prgram Prvider Training The Early Peridic Screening, Diagnsis and Treatment (EPSDT) Care fr Kids prgram is Iwa s Medicaid prgram fr children. The prgram recmmends regular well-child, preventive health visits. These help care prviders identify medical, develpmental and scial-emtinal cncerns in children and adlescents yunger than 21. Medicaid pays fr any medically necessary diagnstic and treatment services fr issues discvered during these exams. Nte: this prgram is nt available t hawk-i members. What Des EPSDT Mean? Early Children shuld receive quality health care frm birth thrugh age 20 that includes identifying, diagnsing and treating medical cnditins as early as pssible. Peridic Children shuld receive well child visits at regular intervals thrugh childhd and adlescence accrding t Iwa EPDST Care fr Kids Health Maintenance Recmmendatins Screening Children shuld be screened fr health, develpmental and behaviral cncerns. Screenings shuld include health histry, develpmental and behaviral assessments, physical exams, immunizatins, lab tests, nutritin/besity preventin, ral health exam, health educatin (anticipatry guidance) and visin and hearing screenings. Diagnsis Children shuld be evaluated fr health, develpmental and scial- emtinal prblems identified during well-child visits. Treatment Children shuld be treated fr health, develpmental r scial- emtinal prblems identified during well-child visits.

2 EPSDT Benefits Members yunger than 21 wh are enrlled in Medicaid are entitled t the fllwing EPSDT benefits: Regular Well-Child Examinatin/Screening Cmprehensive health and develpmental histry including screening f physical and mental health develpment Cmprehensive unclthed physical exam. Apprpriate immunizatins accrding t Centers fr Disease Cntrl and Preventin's Immunizatin Schedules. Lab tests, including lead txicity screening. Educatin abut expected develpmental milestnes, healthy lifestyles and accident and disease preventin. Visin, hearing and dental screening, including referral t a dentist within six mnths f eruptin f first tth r by 12 mnths and fllw up questins abut dental hme status at every visit. Dental services, at a minimum: screening, preventive care, relief f pain and infectins, restratin f teeth and maintenance f dental health Visin services, at a minimum: screening, diagnsis and treatment fr defects in visin, including eyeglasses Hearing services, at a minimum: screening, diagnsis and treatment fr defects in hearing, including hearing aids. Might include fllw-up t newbrn hearing screening Diagnsis When a screening shws a need fr further evaluatin. Treatment and Other Necessary Healthcare T crrect r imprve issues discvered during the screening prcess

3 Peridicity Schedule Explained Iwa Medicaid EPSDT Care fr Kids Peridicity Schedule was updated by the Iwa Department f Human Services and changes* were effective n Octber 31, Histry Initial/Interval Physical Exam Well Visit Sensry Screening Cmprehensive health, nutritin and develpmental histries shuld be reviewed and updated at every visit. 2-5 day visit: Infants need evaluated at 2-5 days ld and within hurs f hspital discharge (assesses feeding and jaundice) Infants discharged prir t 48 hurs f age shuld be seen within 48 hurs f discharge Thirty-mnth visit: A 30-mnth visit is strngly recmmended t screen the child s develpment including language and scial develpment. Anticipatry guidance shuld be prvided including safety prmtin and develpmental milestnes. Older children and adlescents: Annual screening exams are recmmended by the American Academy f Pediatrics (AAP) and by Iwa Medicaid. Please nte, this has nw changed frm the every ther year requirement. *See Peridicity schedule fr frequency f all well visits. UHCCmmunityPlan.cm > Health Prfessinals > Iwa > Prvider Training > EPSDT Care Fr Kids Prgram Health Maintenance Recmmendatins Visin: Assessment fr visin risk shuld be cmpleted at every visit. Instrument screenings shuld be cnsidered annually frm age 1 t 5 years. Evidence f child visin screening is required fr kindergarten and third grade enrllment. Hearing: Universal screening f all newbrns and infants is required by Iwa law. Verify results and fllw up as necessary. Office screening f hearing is recmmended beginning at 4 using an audiscpe, screening audimetry, r tacustic emissins. Useful CPT Cdes fr Well Visits: <1 year , years 99382, years 99383, years 99384, years 99385, Referral: Add the U1 mdifier t the screening cde when a cnditin is identified resulting in a referral fr treatment.

4 Oral Health Develpmental and Behaviral Health Anticipatry Guidance Nutritin/ Obesity Preventin Screening and Risk Assessment: Examinatin f the ral cavity and dentitin with anticipatry guidance related t ral health and dental care is recmmended at every visit. Members shuld be referred t a dental hme by 12 mnths r within 6 mnths f first tth eruptin. Iwa law requires children under age 12 wh receive Medicaid t have a dental hme. Fluride Varnish Applicatins: Fluride varnish may be applied t children every 3-6 mnths in the primary care r dental ffice nce teeth are present frm age 6 mnths t 5 years. Family Risk Factr Screening: Assessment f family risk factrs such as parental depressin, substance use, dmestic vilence, parental histry f abuse, and scial supprts are recmmended at each visit. Tls such as the Bright Futures intake frm r the Scial Histry f the Iwa Child Health and Develpment Recrd can be used t screen fr risk factrs. Develpmental Screening: Screening shuld be cmpleted at 9, 18, and mnths. ASQ-3 is the recmmended screening tl t assess develpment. Autism Screening: Screening shuld be cmpleted at 18 and 24 mnths. M-CHAT R/F is the recmmended screening tl. Any child suspected f an autism spectrum disrder shuld be referred fr services and diagnstic evaluatin immediately, and they shuld receive an audilgical evaluatin. Depressin Screening: Screening fr depressin f children and adlescents is recmmended beginning at 12 years. Tbacc, Alchl, and Drug Use Screening: Screening fr alchl, tbacc, and substance use is recmmended t be cmpleted annually beginning at 11 years by directly asking abut usage r experimentatin. Tls such as the CRAFFT screening tl can be helpful fr identifying prblematic substance use. Practical health infrmatin shuld be given t parents regarding significant physical, emtinal, and psychlgical milestnes. Assessment and anticipatry guidance related t nutritin and besity shuld be cmpleted at every visit with interventin as needed. Fluride Varnish Applicatin: CPT Cde Separate billing fr bjective develpmental, behavir and mental health screening n the same date f service as a well visit is allwed by Medicaid. Standardized Screening Tl: CPT Cde Caregiver Depressin Screening: CPT Cde Adlescent Depressin Screening: CPT Cde Referral: Add the U1 mdifier t the screening cde when a cnditin is identified which results in a referral fr treatment.

5 Prcedures Immunizatins: Age apprpriate immunizatins shuld be administered per the CDC immunizatin guidelines. The child s immunizatins shuld be checked at every visit t mnitr fr any pprtunity t cmplete any needed r verdue immunizatins. Hemglbin/Anemia: An initial test shuld be cmpleted at 12 mnths fr all individuals. Any members at risk shuld als receive a screen at 4 mnths, 15 mnths, and every visit afterwards. Lead Screening: Lead risk assessment using the IDPH lead questinnaire shuld begin at 6 mnths. Fr all children testing shuld be cmpleted at 12 and 24 mnths. Fr members with higher risk, the initial test shuld be cmpleted when high risk level is determined, as well as 12, 18, and 24 mnths, and then annually up t age 6. Lipid Screening: Assessment fr high risk shuld be cmpleted at 24 mnths, and 4, 6, 8, and years. Children with high risk shuld be screened with a fasting lipid prfile. All children shuld be tested between 9 and 11 years and between 17 and 21 years. Fr members wh are nt at high risk, nn-fasting nn-hdl chlesterl can be used. STI/HIV Screening: Sexually transmitted infectin screening shuld be cmpleted fr adlescents per the AAP Red bk recmmendatins. HIV screening is recmmended fr all members frm 16 t 18 years ld. Members determined t be at high risk shuld be tested annually. In the state f Iwa, the law requires minrs t give written cnsent fr HIV testing and treatment and they must be infrmed that their legal guardian will be ntified if the test is psitive. Tuberculsis Risk Assessment: High risk grups including thse at risk fr clse cntact with the disease (recent immigrants r refugees frm cuntries where TB is cmmn, residents f crrectinal institutins r hmeless shelters, members with certain underlying medical disrders, etc.) shuld be tested annually. Cervical Dysplasia Screening: Rutine screening fr cervical dysplasia are recmmended starting at age 21. Indicatins fr pelvic exams prir t 21 years can be fund in the 2010 AAP statement Gyneclgic Examinatin fr Adlescents. Separate billing fr labratry testing and administratin f vaccines n the same date f service as a well visit is allwed by Medicaid. Immunizatins CPT Cdes: DTaP , 90700, 90721, Hep A Hep B , 90740, 90744, HiB , 90698, 90721, HPV Influenza 90655, 90657, , 90673, 90685, IPV , 90713, Meningcccal , 0734 MMR , PCV Rtavirus Tdap VZV , Lead Screening: CPT Cde We re here t help If yu have questins, ask fr the EPSDT crdinatr by calling Prvider Services at r visit UHCprvider.cm fr mre infrmatin.

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