Wiki Well Child Check first year

[dawner40]

I'd like to know how other facilities code the WCC for the first year if they are coming in the first month for a weight check? Our providers only want to use the 99391 at 2 weeks, 4 weeks, and 2-4-6-9- and 12 mos. Anything in between they don't want to use the 99391. So for weight checks, jaundice checks, with all the other elements of a wellness check with no real diagnosis we are using Z01.89 encounter for other specified special examinations. And use 99212-99215 CPT's. I can't find any guidance to how often they can use the 99391 the first year. Anyone know the answer to that question?

 

[rthomas@impcna.com]

I'd like to know how other facilities code the WCC for the first year if they are coming in the first month for a weight check? Our providers only want to use the 99391 at 2 weeks, 4 weeks, and 2-4-6-9- and 12 mos. Anything in between they don't want to use the 99391. So for weight checks, jaundice checks, with all the other elements of a wellness check with no real diagnosis we are using Z01.89 encounter for other specified special examinations. And use 99212-99215 CPT's. I can't find any guidance to how often they can use the 99391 the first year. Anyone know the answer to that question?

It's going to depend on the payers guidelines as to how many wellness visits they allow in the first year. In our practice we do 99391 at 3-5day, 2 weeks and
2month - 12 month. The only time we have patient comes in for weight check only is if there hasn't been weight gain, feeding problems or FTT. For weight checks only we charge a 99211 nurse visit since they only see a nurse unless the baby has lost weight or still isn't gaining and a provider gets involved. For jaundice checks since we have an in house lab so we just do the lab only.

 

[commitsvs]

Normally - Most of the insurance companies follow this.

AAP Schedule of Well-Child Care Visits​

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.
The Bright Futures/American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the "periodicity schedule." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits​

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old