Kev Mus Saib Me Nyuam Zoo hauv Thawj 15 Lub Hlis Daim Ntawv Qhia

Cov nyiaj pab txhawb nqa raug them rau tus kws kho mob thawj zaug (PCP) txhua xyoo, tom qab xaus rau lub quarter thib plaub. Yog xav paub ntxiv, mus saib CBI Technical Specifications.

• Administrative members on date of 15-month birthday.
• Cov tswv cuab ob tog.
• Cov tswv cuab hauv kev saib xyuas thaum kawg ntawm lub neej, tau txais cov kev pabcuam thaum kawg ntawm lub neej lossis cov uas tau tuag thaum lub xyoo ntsuas.

Cov ntaub ntawv yuav tsum muaj ib daim ntawv qhia tias kev mus ntsib nrog PCP, thiab cov ntaub ntawv pov thawj ntawm tag nrho ntawm cov hauv qab no:

• Keeb kwm kev noj qab haus huv: Kev soj ntsuam keeb kwm ntawm tus tswv cuab muaj mob lossis muaj mob (kev ua xua, tshuaj, kev txhaj tshuaj tiv thaiv kab mob).
• Keeb kwm kev loj hlob ntawm lub cev: Kev ntsuam xyuas cov ntsiab lus tshwj xeeb ntawm kev loj hlob ntawm lub cev uas haum rau hnub nyoog ntawm tus tswv cuab.
• Mental Development History: Kev ntsuam xyuas cov ntsiab lus tseem ceeb ntawm kev loj hlob ntawm lub hlwb uas haum rau hnub nyoog ntawm tus tswv cuab.
• Kev kuaj lub cev.
• Kev qhia txog kev noj qab haus huv / kev qhia kev cia siab: Tus PCP muab rau cov niam txiv/tus saib xyuas vim nws xav txog tej teeb meem uas tus menyuam thiab tsev neeg yuav ntsib.

Zoo mus xyuas CPT Codes: 99381, 99382, 99391, 99392, 99461

Zoo mus xyuas ICD-10 Codes: Z00.110, Z00.111, Z00.121, Z00.129, Z00.2, Z76.1, Z76.2, Z02.5, Z02.84

Cov Nqi Them Nqi: Rau cov tswv cuab hnub nyoog 0-35 lub hlis (txog hnub ua ntej hnub yug 36 lub hlis), kev mus ntsib kws kho mob menyuam yaus yuav tsum tau them txhua 14 hnub.

Thov saib cov lus qhia ntawm American Medical Association (AMA) rau kev them nqi rau kev mus ntsib kws kho mob menyuam yaus nrog rau kev mus ntsib kws kho mob hauv tib hnub. Nco ntsoov tias cov ntaub ntawv kho mob xav tau cov ntaub ntawv txhawb nqa los qhia txog cov kev pabcuam sab nraud ntawm kev mus ntsib kws kho mob menyuam yaus.

Cov ntaub ntawv rau qhov kev ntsuas no yog sau los ntawm kev siv cov ntawv thov, DHCS cov ntawv thov them nqi rau kev pabcuam, thiab cov ntaub ntawv xa los ntawm cov neeg muab kev pabcuam los ntawm Cov Cuab Yeej Xa Cov Ntaub Ntawv (DST) ntawm Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv. Txhawm rau nrhiav qhov khoob hauv cov ntaub ntawv:

• Run a report from your electronic health record (HER) system; or
• Manually compile patient data. For example, download the monthly Well-Child Visits 0-15 Months quality report or your Care-Based Incentives Measure Details report on the Provider Portal and compare to your EHR/paper records.

This measure allows providers to submit well-child visits billed under the mother’s Medi-Cal ID, as well as visits that were completed during a gap in coverage, from the clinic EHR system or paper records to the Alliance by the DST contractual deadline. Visits that were originally billed under the mother’s Medi-Cal ID need to be submitted under the child’s Medi-Cal ID. To submit, upload data files to the DST on the Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv. Yuav kom txais tau, cov ntaub ntawv yuav tsum xa ua CSV cov ntaub ntawv. Cov lus qhia ib kauj ruam yog kauj ruam muaj nyob rau hauv Cov Ntaub Ntawv Xa Cov Cuab Yeej Qhia ntawm Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv.

• Well-child visits should occur at the following intervals:
  

  Yug (hauv tsev kho mob)	Muaj 6 lub hlis
  3-5 hnub (tom qab tso tawm hauv tsev kho mob)	Muaj 9 lub hlis lawm
  Muaj 1 lub hlis	Muaj 12 lub hlis
  Muaj 2 lub hlis lawm	Muaj 15 lub hlis
  Muaj 4 lub hlis lawm

  Saib Bright Futures/American Academy of Pediatrics Cov Lus Qhia rau Kev Kho Mob Me Nyuam Yaus Tiv Thaiv rau daim ntawv teev sijhawm ua tiav txog hnub nyoog 21 xyoos, nrog rau Cov Khoom Siv thiab Cov Cuab Yeej Ci Ntxim Yav Tom Ntej.

• Catch up: Well-child visits are billable every 14 days until the day before the child’s third birthday. For example, if an infant has their two-month well-child visit at three months of age, the infant can still be seen for their four-month visit if the visits are 14 days apart.
• Schedule visits for the next six months before the member leaves the exam room or clinic thiab muab ib daim ntawv qhia txog yam uas yuav them rau thaum mus ntsib kws kho mob tom ntej. Qhov no ua kom tus menyuam nyob raws sijhawm rau qhov kev mus ntsib kws kho mob uas tsim nyog.
• Siv cov neeg pab kho mob los tsim cov lus txib uas tseem tab tom tos nyob rau hauv EHR rau txhua qhov kev txhaj tshuaj tiv thaiv kab mob uas yuav tsum tau txhaj thaum lub sijhawm mus ntsib kws kho mob. Tus kws kho mob yuav tsum tshem tawm daim ntawv xaj txhaj tshuaj tiv thaiv kab mob thaum lub sijhawm mus ntsib kws kho mob yog tias lawv tsis tuaj yeem muab kev txhaj tshuaj tiv thaiv kab mob rau tus menyuam. Txoj kev no ua kom ntseeg tau tias muaj cov lus ceeb toom rau kev txhaj tshuaj tiv thaiv kab mob uas xav tau thaum lub sijhawm mus ntsib kws kho mob txhua zaus.
• Leverage tsis muaj cib fim (episodic and sick visits) to increase preventive services (immunizations), as well as convert acute visits into well-child visits (sports physicals).
• Saib xyuas lub Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv cov ntawv ceeb toom ua ib qho cuab yeej los txheeb xyuas cov tswv cuab uas yuav tsum tau mus ntsib lawv tus menyuam kom zoo.
• Tsim ib tus qauv or use age-specific standardized templates in your EHR to maximize documentation of Bright Futures requirements and trigger reminders for the next well-child visits.
• Txhawb nqa tus cwj pwm noj qab haus huv thiab ntsuam xyuas tus cwj pwm pheej hmoo los txheeb xyuas cov xwm txheej uas yuav cuam tshuam rau kev loj hlob ntawm lub cev, kev sib raug zoo thiab kev xav.
• Xyuas kom meej tias txhua tus menyuam tau txais kev tshuaj xyuas kev loj hlob, tsawg kawg, thaum muaj cuaj lub hlis, 18 lub hlis, 24 lossis 30 lub hlis. Yog tias tus menyuam muaj feem yuav muaj teeb meem kev loj hlob ntau dua, tej zaum yuav tsum tau kuaj ntxiv.
• Pab pawg mus ntsib menyuam yaus are shown to be as effective as individual well-child visits. Parents have longer visits with more content, which is associated with more anticipatory guidance, family-centered care, and parent satisfaction.¹
• Xa mus rau lub Cov Kev Teem Caij Txhaj Tshuaj Tiv Thaiv Kab Mob Rau Menyuam Yaus thiab Cov Hluas Uas Pom Zoo los ntawm American Academy of Pediatrics.

¹Coker, T., Windon, A., Moreno , C., Schuster, M., Chung, P. Kev Kho Mob Menyuam Yaus Zoo Dua Tshiab rau Cov Menyuam Yaus: Kev Tshuaj Xyuas Cov Tswv Yim thiab Cov Cuab Yeej. Kev Kho Mob Me Nyuam. 2013 Lub Peb Hlis; 131 (Suppl 1): S5–S25.

• Kev Pabcuam Kab Lis Kev Cai thiab Lus ntawm Alliance muaj rau cov neeg muab kev pabcuam hauv network.
  • Cov Kev Pab Txog Lus - Thov cov ntaub ntawv ntawm 800-700-3874, ext. 5504.
  • Kev Pab Txhais Lus Hauv Xov Tooj - Hu ncaj qha rau tus neeg txhais lus hauv xov tooj 24 teev hauv ib hnub, 7 hnub hauv ib lub lim tiam.
  • Kev Pab Txhais Lus - Thov tau rau lub sijhawm teem tseg nrog tus tswv cuab.
  • Kev Pabcuam Txhais Lus Nyob Deb (VRI) - Thaum tus neeg txhais lus ntawm tus kheej tsis muaj lossis tsis yooj yim rau kev nkag mus.
  • Yog xav paub ntxiv txog Kev Pabcuam Kab Lis Kev Cai thiab Kev Kawm Lus, hu rau Alliance Health Education Line ntawm 800-700-3874, ext. 5580 lossis email rau peb ntawm [email protected].
• Kev Pabcuam Thauj Mus Los ntawm Alliance rau cov neeg mob uas muaj teeb meem kev thauj mus los.
  • Yog xav tau kev pab thauj neeg mob uas tsis yog xwm txheej ceev (NEMT), hu rau 800-700-3874, ext. 5640 (TTY: Hu 711).
  • Yog xav tau kev pab thauj mus los uas tsis yog kev kho mob (NMT), hu rau 800-700-3874, ext. 5577 (TTY: Hu 711).
• Alliance Infant Wellness Map is available to providers upon request. This resource gives parents awareness of the importance and timing of infant well-child visits, immunizations and developmental milestones. Contact your Provider Relations Representative to request this resource for your clinic.
• Well Visit Planner - Family Resource Sheets los ntawm lub hnub nyoog ntawm menyuam yaus lossis thaj chaw mus ntsib kws kho mob - Lub Chaw Ntsuas Kev Noj Qab Haus Huv ntawm Menyuam Yaus thiab Cov Hluas.
• Kev Saib Xyuas Menyuam Yaus Zoo: Kev Txhim Kho Kev Mus Saib Xyuas Menyuam Yaus Zoo – Medicaid.gov.
• Maternal & Infant Health Care Quality – Medicaid.gov.
• Cov Cuab Yeej Txhim Kho Cov Kev Pabcuam Tiv Thaiv Rau Cov Menyuam – Chaw rau Cov Tswv Yim Kev Kho Mob, Inc.
• Kev Pab Cuam Kauj Ruam Ua Rau Kev Saib Xyuas Menyuam Yaus Zoo Thiab Kev Txhaj Tshuaj Tiv Thaiv Kab Mob Ntau Ntxiv Rau Cov Neeg Tsis Muaj Peev Xwm - Lub Koom Haum American Academy of Pediatrics.
• Tshem tawm cov teeb meem thiab txhim kho kev nkag mus rau kev kho mob tiv thaiv - Lub Koom Haum Kws Kho Mob Tsev Neeg Asmeskas.
• Cov peev txheej Medi-Cal rau Cov Menyuam Yaus thiab Cov Hluas – Department of Health Care Services.