Child Health Check-Up (formerly EPSDT) - Herman & Associates ...
Child Health Check-Up (formerly EPSDT) - Herman & Associates ...
Child Health Check-Up (formerly EPSDT) - Herman & Associates ...
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CHILD HEALTH CHECK-UPCOVERAGE AND LIMITATIONS HANDBOOKTable of ContentsChapter/TopicPageIntroductionHandbook Use and Format ............................................................................................ iiCharacteristics of the Handbook .................................................................................... iiiHandbook <strong>Up</strong>dates....................................................................................................... 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................................................................................................. 2-1<strong>Child</strong> <strong>Health</strong> <strong>Check</strong>-<strong>Up</strong> Periodicity Schedule................................................................. 2-4Comprehensive <strong>Health</strong> 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 ......................................................................................................... 2-17<strong>Health</strong> 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: <strong>Child</strong> <strong>Health</strong> <strong>Check</strong>-<strong>Up</strong> Tracking Forms .....................................................B-1Appendix C: Initial Comprehensive <strong>Health</strong> and DevelopmentalHistory Form ...........................................................................................................C-1Appendix D: Recommendations for Preventive Pediatric <strong>Health</strong> Care...............................D-1Appendix E: Behavioral <strong>Health</strong> and Developmental Screening Form ................................E-1Appendix F: Lead Poisoning Risk Assessment.............................................................F-1Appendix G: <strong>Child</strong> <strong>Health</strong> <strong>Check</strong>-<strong>Up</strong> Audit Tool............................................................ G-1