Pediatric Coding Alert

Bright Futures guidelines can benefit your practice while helping your patients.

Now in its 25th year, and currently in its fourth edition, the Bright Futures guidelines have been called the gold standard of preventive care for pediatric medicine. In fact, they have become so highly regarded that they became the centerpiece of the preventive care policies for children outlined in the Affordable Care Act of 2010.

Consequently, health plans now have to cover the “regular pediatrician visits, vision and hearing screening, developmental assessments, immunizations, and screening and counseling to address obesity” that the guidelines recommend (Source: www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/preventive-care-background.html).

You know that implementing the guidelines benefits your patients. But do you know how much they will also benefit your practice? Here are three ways to make Bright Futures a win-win for you, your pediatrician, and your patients and families, along with numerous resources that will help you in adopting, or adapting, the guidelines to everyone’s advantage.

Let Bright Futures Aid in Compliance

At first glance, the sheer number of examinations, tests, procedures, and behavioral and sensory screenings outlined in the 800-plus pages of Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents can seem overwhelming. In fact, this can be a huge obstacle to implementation in many pediatric practices.

“I find that some pediatricians reject it altogether because it can appear overwhelming,” says Alanna Levine, MD, FAAP, a practicing pediatrician with Orangetown Pediatric Associates in Orangeburg, New York. “You cannot possibly address all of the Bright Futures recommendations at every visit,” Levine adds.

That’s why the Periodicity Schedule (www.aap.org/en-us/Documents/periodicity_schedule.pdf) “is great to use as a guideline,” Levine believes. But using the schedule can go much further than that. “It is also incredibly useful in making sure we are utilizing evidence-based screening/testing at the appropriate time during well visits,” says Levine.

It is a view echoed by many in pediatric care. “Many offices are using Bright Futures as a guideline for performing screenings, testings, and when to administer vaccines,” says Donelle Holle, RN, president of Peds Coding Inc., and a healthcare, coding, and reimbursement consultant in Fort Wayne, Indiana. “I believe that, when they do follow the Bright Future guidelines, pediatric practices are also more compliant with what is needed in well-care services while providing the best care possible to children,” Holle believes.

Use this Bright Futures coding resource: For a comprehensive list of CPT^® and ICD-10 codes associated with Bright Futures preventive care services, counseling, and risk-factor reduction services, screenings, and immunization administration, go to: www.aap.org/en-us/Documents/coding_preventive_care.pdf?utm_source=bright_futures_enews0315&utm_medium=email&utm_campaign=bright_futures_web_site.

Employ Bright Futures to Provide Patient Resources

Aside from providing your pediatrician with all the resources needed to provide effective preventive care for your patients, the Bright Futures website offers a vast amount of resources that will save you time and energy when it comes to reinforcing your pediatrician’s well care efforts and documenting patient visits. While some of the resources are only available through subscription (such as those found at toolkits.solutions.aap.org/bright-futures/core-forms), their scope and authority make them invaluable to most practices.

“The Bright Futures handouts are very beneficial as they cover a wide variety of topics from temper tantrums to teen issues,” notes Holle. Clinical staff can present the handouts to the families, which enables the physician not only to document that the handouts were given but also to discuss them, adding greater value to the well care visit.

Use Bright Futures to Boost Your Bottom Line

The last, but by no means least, benefit of adopting the Bright Futures guidelines is financial. First, you can “use the Periodicity Schedule when negotiating payments with insurance companies to make sure they are paying for the recommended screenings,” Levine points out.

Additionally, Bright Futures can be incorporated into your electronic health record (EHR) in a number of ways that can help add to your revenue. For example, if you integrate the guidelines into your EHR, you can run reports to locate patients that have missed well-child appointments or scheduled vaccinations and reschedule them. And Bright Futures documentation, including developmental screenings and test results, can be stored and used to provide additional support when it comes time to bill for all the components associated with this most vital of pediatric services.

(For further information on integrating Bright Futures guidelines into your EHR, go to brightfutures.aap.org/clinical-practice/Pages/Integrate-Bright-Futures-Into-Your-Electronic-Health-Record-System.aspx. And for the full guidelines, see Hagan J. F., Shaw J.S., Duncan P., eds. Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. 4th ed. Elk Grove Village, IL. American Academy of Pediatrics, 2017.)