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COVID-19

HEDIS Measure - 15 Months

Answer the questions to confirm eligibility and compliance criteria, this is applicable to Medicaid and Commercial members only.

Does the member* turn 15 months of age during the measurement year?

Does the member have 0, 1, 2, 3, 4, 5, 6 or more well-child visits with a Primary Care Provider (PCP), on different dates of service, on or before the child’s 15-month birthday that contain ALL of the following criteria?

Documentation of:

  1. A health history
  2. A physical developmental history
  3. A mental developmental history
  4. A physical exam
  5. Health education/anticipatory guidance

Member does not meet compliance for this measure

Billing Codes

  • 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

Member meets compliance for this measure.