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Well-Child Visits in the First 30 Months of Life (W30)

HEDIS Measure

Well-Child Visits in the First 30 Months of Life (W30)

Line of business: Commercial Medicaid

Data Collection Method: Administrative

Measure Description

The percentage of members who had the following number of well- child visits with a PCP during the last 15 months.

The following rates are reported:

  • Well-Child Visits in the First 15 Months. Children who turned 15 months old during the measurement year: Six or more well-child visits.
  • Well-Child Visits for Age 15 Months–30 Months. Children who turned 30 months old during the measurement year: Two or more well-child visits.

Numerator Compliance

Rate 1 – Well Child Visits in the First 15 Months of Life: Six or more well-child visits on different dates of service on or before the 15-month birthday.

Rate 2 – Well Child Visits for Ages 15 Months – 30 Months of Life: Two or more well-child visits on different dates of service between the child's 15-month birthday plus 1 day and the 30- month birthday.

NOTE: The well-child visit must occur with a PCP, but the PCP does not have to be the practitioner assigned to the child.

Best Practices

  • Take advantage of every visit, including sick visits, to capture the components of this measure
  • Schedule visits within the recommended time frames
  • Use standardized templates in charts and EMRs that allow checkboxes for standard counseling activities
  • Based on the well visit schedule by the American Academy of Pediatrics – there are seven opportunities of capture these visits: Newborn (not just weight check) 1, 2, 4, 6, 9, 12, 15, 18, 24, 30 months
  • Encourage parents/patients to maintain the relationship with a PCP to promote consistent and coordinated health care
  • Educate parents/patients on the importance of having preventive care visits
  • Consider offering extended practice hours to increase care access
  • Remind patients of their appointment by making calls or sending texts
  • Make outreach calls and/or send letters to advise members of the need for a visit
  • Partner with Horizon Healthy Journey Program to assist with targeted outreach activities

Referent BRIGHT FUTURES

  • A national health promotion and prevention initiative led by the American Academy of Pediatrics (AAP)
  • Provides theory and evidence-based guidance for all preventive care screenings and well-child visits
    brightfutures.aap.org/Pages/default.aspx

Quality Value Set Directory Coding Tips

Well-Care

CPT

  • 99381
  • 99382
  • 99383
  • 99384
  • 99385
  • 99391
  • 99392
  • 99393
  • 99394
  • 99395
  • 99461

HCPCS

  • G0438
  • G0439
  • S0302
  • S0610
  • S0612
  • S0613

ICD10CM

  • Z00.00
  • Z00.01
  • Z00.110
  • Z00.111
  • Z00.121
  • Z00.129
  • Z00.2
  • Z00.3
  • Z01.411
  • Z01.419
  • Z02.5
  • Z76.1
  • Z76.2

SNOMED CT US Edition

  • 103740001
  • 170099002
  • 170107008
  • 170114005
  • 170123008
  • 170132005
  • 170141000
  • 170150003
  • 170159002
  • 170168000
  • 170250008
  • 170254004
  • 170263002
  • 170272005
  • 170281004
  • 170290006
  • 170300004
  • 170309003
  • 171387006
  • 171394009
  • 171395005
  • 171409007
  • 171410002
  • 171416008
  • 171417004
  • 243788004
  • 268563000
  • 270356004
  • 401140000
  • 410620009
  • 410621008
  • 410622001
  • 410623006
  • 410624000
  • 410625004
  • 410626003
  • 410627007
  • 410628002
  • 410629005
  • 410630000
  • 410631001
  • 410632008
  • 410633003
  • 410634009
  • 410635005
  • 410636006
  • 410637002
  • 410638007
  • 410639004
  • 410640002
  • 410641003
  • 410642005
  • 410643000
  • 410644006
  • 410645007
  • 410646008
  • 410647004
  • 410648009
  • 410649001
  • 410650001
  • 442162000
  • 783260003
  • 444971000124105
  • 446301000124108
  • 446381000124104
  • 669251000168104
  • 669261000168102
  • 669271000168108
  • 669281000168106