Georgia Chapter American Academy of Pediatrics

DEDICATED TO THE HEALTH OF ALL CHILDREN

Winner of Outstanding Chapter Award 1965, 1996, 2000, 2004, 2009   


 

 

 

Oral Health

                                               Chapter Chair of the Oral Health Task Force, Rob Forbes, MD

 

Promoting Oral Health

The American Academy of Pediatrics’ new Bright Futures Recommendations for Preventive Pediatric Health Care indicates that an oral health risk assessment be done at ages 6 and 9 months.  A referral to a dental home (if available) should be made at 12, 18, 24 and 30 months.  If a dental home is not available at those ages, an oral health risk assessment should be done. 

Also, if the primary water source for the child is not fluoridated, consider oral fluoride supplementation.  Click here to view the new periodicity chart. Click here for a summary of changes to the periodicity schedule.  To view the American Academy’s policy statement entitled, Oral Health Risk Assessment Timing and Establishment of the Dental Home published in Pediatrics in May 2003, please click here.

Since 2002, Georgia’s Medicaid EPSDT program, HealthCheck has required the following:

Children must be referred to a dentist for routine dental care for members as early as 12 months of age.  However, if indicated, a dental referral may be made at any age.  An inspection of the mouth must be a part of each screen.  If HealthCheck provider identifies any spot during oral exam, refer the member to a dentist immediately.  Discuss the importance of good oral hygiene with member/caregiver.

Georgia Medicaid Coverage for Application of Fluoride Varnish for Children

The Georgia Department of Community Health (DCH), Georgia Medicaid program provides reimbursement for the application of fluoride varnish by physicians in the Medicaid Fee for Service (FFS) Program. The three Medicaid CMOs were notified of this new coverage benefit and it is our current understanding that all 3 will follow Medicaid FFS and begin paying for this service.

This service can billed using CPT D1206 and can be billed on the form 1500. The service is billable under the following Categories of Service: 430 (Physician Services), 431 (Physician’s Assistant Services), and 740 (Nurse Practitioners). When done in a physician’s office, the procedure can be delegated to appropriate clinical staff. The reimbursement amount is $17.59. The service can be provided for children aged one month through 13 years, 11 months of age, twice annually. The code is already open and further details will be included in the July 1 version of the Medicaid Health Check manual, available on the Georgia Health Partnership web portal.

Documentation:

The dental referral must be documented in the medical record.  Document education on Good Oral Hygiene practices.

Visit the Georgia Health Partnership web page at www.mmis.georgia.gov  to viewthe Medicaid Provider Manuals such as the Health Check Manual and Dental Services Manual.

Locate a Pediatric Dentist

Click here to locate a pediatric dentist at Georgia Academy of Pediatric Denistry

Oral Health Partners & Georgia Initiatives

Georgia Oral Health Coalition

The Georgia Oral Health Coalition (GOHC) was formed in 1996 to enhance the infrastructure of the Oral Health Section, Georgia Department of Public Health. The GOHC remains instrumental in addressing oral health infrastructure for the state. The in-kind contribution of agencies and organization as well as donated time of individuals in the GOHC resulted in major changes that retained and expanded the state oral health infrastructure.

Georgia Department of Public Health Oral Health Initiatives

DPH’s Georgia Oral Health Prevention Program uses portable dental equipment to bring children services such as dental sealants and fluoride rinses to prevent cavities; cleaning and examinations; and referrals to public and private dentists for treatment, in addition to prevention education. Eleven mobile dental trailers and vans are in the field, up from two vans in 2000. Public Health also treats children in public health clinics in 36 counties, some paid for in part by county and municipal funds.  Click here for further details on Georgia Public Health Initiatives regarding Oral Health

 Oral Health Resources

 American Academy of Pediatrics Resources

To learn more about AAP educational and training resources click here. To view a video on how to apply fluoride varnish click here.

Return to the Georgia Chapter AAP home page