Child Health Check-Up (formerly EPSDT) - Herman & Associates ...

CHILD HEALTH CHECK-UPCOVERAGE AND LIMITATIONS HANDBOOKTable of ContentsChapter/TopicPageIntroductionHandbook Use and Format ............................................................................................ iiCharacteristics of the Handbook .................................................................................... iiiHandbook Updates....................................................................................................... iiiChapter 1 – Provider Qualifications and EnrollmentPurpose and Description............................................................................................. 1-1Provider Qualifications ................................................................................................ 1-3Provider Enrollment .................................................................................................... 1-4Provider Responsibilities ............................................................................................. 1-4Chapter 2 - Covered Services, Limitations, and ExclusionsService Requirements................................................................................................. 2-1Child Health Check-Up Periodicity Schedule................................................................. 2-4Comprehensive Health and Developmental History ........................................................ 2-6Nutritional Assessment .............................................................................................. 2-7Developmental Assessment ........................................................................................ 2-8Comprehensive Unclothed Physical Examination .......................................................... 2-9Dental Screening ..................................................................................................... 2-10Sensory Screenings ................................................................................................. 2-10Laboratory Tests...................................................................................................... 2-12Immunizations ......................................................................................................... 2-17Health Education, Anticipatory Guidance ................................................................... 2-18Chapter 3 - Procedure Codes, Diagnosis Codes, Referral Codes and ReimbursementProcedure Code Information ........................................................................................ 3-2Diagnosis Code Information......................................................................................... 3-3Referral Code Information............................................................................................ 3-4Reimbursement Information......................................................................................... 3-4AppendicesAppendix A: Provider Types and Maximum Fees ..........................................................A-1Appendix B: Child Health Check-Up Tracking Forms .....................................................B-1Appendix C: Initial Comprehensive Health and DevelopmentalHistory Form ...........................................................................................................C-1Appendix D: Recommendations for Preventive Pediatric Health Care...............................D-1Appendix E: Behavioral Health and Developmental Screening Form ................................E-1Appendix F: Lead Poisoning Risk Assessment.............................................................F-1Appendix G: Child Health Check-Up Audit Tool............................................................ G-1