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 (Claims)
Rate 1 Only
Supplemental Data Submission
- Standard – Electronic Clinical Data System (ECDS) Layout
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