Bright Futures

Bright Futures Preventive Services: Coding Guidelines

The American Academy of Pediatrics has released Achieving Bright Futures Preventive Services Coding Guidelines to provide guidance to insurers, regulators, lawmakers, and other pediatric health care stakeholders regarding the new Affordable Care Act Pediatric Preventive Services Provision.

Bright Futures

The American Academy of Pediatrics (AAP) Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents 3rd Edition along with its new Recommendations for Preventive Pediatric Health Care (periodicity schedule) in 2008 are now the standard for pediatric care. To view these recommendations and obtain additional resources regarding Bright futures click here.  The AAP encourages practices to review the schedule against their practice protocols.

Also, Georgia Medicaid uses the AAP/Bright Futures Periodicity schedule as its guide for its Early Periodic Screening, Diagnostic, and Treatment (EPSDT).

If you would like an in-office presentation on Bright Futures for you and your office staff, please contact Fozia Khan Eskew at the Chapter office via email at feskew@gaaap.org or via phone at 404-881-5074.

APP Resources

Performing Preventive Services: A Bright Futures Handbook

This AAP Handbook is a companion piece to Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition.  The AAP notes that this handbook can be used in the pediatric practice and as a teaching tool for medical students, residents, and all health professionals who provide well child care. Click here to view the 5 main sections of the handbook which are each downloadable in PDF format.

Pediatric Care on Line™

AAP offers this service to Academy members.  The system includes resources to implement Bright Futures prevention guidelines. Forms to document every well child exam from infancy to early childhood, middle childhood, and adolescence are included at no cost to Academy members. Additionally history questionnaires, pre-visit questionnaires to document recommended risk assessments, visit-specific parent and patient handouts, medical screening questionnaires, and problem lists are also available. Click here for details.

Children 1st

Pediatrician’s Guide to Public Health Programs for Children

This brief guide will help you navigate through a variety of programs offered through the Georgia Division of Public Health that may benefit your patients.  If you would like copies of the guide, please contact Kasha Askew, at the Chapter office at 404-881-5067 or email her at kaskew@gaaap.org.  Click Here for a copy of the Guide.

Children 1st  is the entry point into Georgia’s Public Health system for children birth to five.  The core functions of Children 1st include early identification of all children with conditions that place them at risk for poor health and/or developmental outcomes; especially through screening of Georgia’s Electronic Birth Certificates.  Additionally, Children 1st supports developmental screening activities throughout Georgia to identify children in need.

Assessment of family strengths and needs is obtained through a Maternal and Child Health Assessment tool.  Linkages to a medical home and community and public health programs and services is also provided.  Monitoring of the child’s health and development can take place either through contact with the child’s medical home or direct contact with the family at various intervals up until the child reaches age five.  Click here for a listing of Children 1st Coordinators.  Click here to obtain a copy of the Children 1st Screening and Referral form.  Click here to view Instructions to complete the form

Great Start Georgia:  Maternal Infant Early Childhood Home Visiting (MIECHV)

Children 1st is participating in Great Start Georgia an initiative through the Governor’s Office for Children and Families which will include an Information Referral Center (IRC). The IRC will identify all children born in Georgia who are at risk for poor health and development through Georgia’s Electronic Birth Certificate system. The Central Intake Call Center will take referrals, link families to public and private services, and manage a resource directory. The toll-free number for this call center is 1-855-707-8277.  Families in Children in Clarke, Crisp, DeKalb, Glynn, Houston, Muscogee, and Whitfield Counties will be eligible to participate in Maternal Infant Early Childhood Home Visiting (MIECHV) program.

Georgia’s Online Analytical Statistical Information System ( OASIS )

OASIS is a standardized health data repository and provides aggregate birth and death data by counties and by years.

Georgia Birth Defects Reporting and Information System

The Georgia Birth Defects Reporting and Information System (GBDRIS) is a surveillance system designed to provide information on incidence, prevalence, trend and epidemiology of birth defects.  Cases of birth defects are reportable to the Division of Public Health through the GBDRIS within 7 days of the confirmatory diagnosis.

Other Public Health Programs and Services

Georgia Healthy Homes and Lead Poisoning Prevention (GHHLPPP)

Click here for information on Georgia’s surveillance system for blood lead levels and environmental tests results and selected healthy homes variables.

Georgia Tobacco Quit Line Now Available Teens

The Georgia Tobacco Quit Line is a free resource that is now able to help tobacco users ages 13 and older. Quit Line can be reached by calling 1-877-270-STOP. Spanish speakers are encouraged to dial: 1-877-2NO-FUME; TTY: 1-877-777-6534 for the hearing impaired. The Quit Line provides counseling, a resource library, and support and referral services over the phone. Georgia Tobacco Quit Line educational materials are available to post in your office or to give to your patients.

Please visit www.livehealthygeorgia.com to review the materials. For additional information and to order materials for your practice, call 404-367-2762.

Please contact the Chapter’s Early Intervention Coordinator, Fozia Khan Eskew, at 404-881-5074
or via email at feskew@gaaap.org if you have any questions regarding the information on this webpage.

Safe To Sleep

Sudden Infant Death Syndrome (SIDS) remains the third leading cause of infant death and the main cause of postneonatal death. However, as the number of accidental infant deaths associated with suffocation and strangulation in bed quadrupled between 1984 and 2004, the Academy responded by revising its policy statement and technical reports on SIDS. Both the policy statement and technical report are titled SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping EnvironmentClick here to view the 2016 policy statement.
While abnormalities in an infant’s brain stem and cardiac arrhythmias are attributed to SIDS, other environmental risks can make an infant vulnerable. These risks include stomach sleeping, soft bedding, lack of breastfeeding, incomplete immunizations, bed sharing, overheating, and exposure to maternal smoking, alcohol and illicit drug use.  Additionally, new data is immerging that suggests that pacifier use cuts the risk of SIDS in half. Given these new risk factors the Back to Sleep campaign has been converted to the Safe Sleep campaign.

AAP Resources

Click on the items below to review each publication:

Local Resources

SIDS Alliance:  The SIDS Alliance of Georgia and the Division of Public Health are dedicated to supporting families coping with SIDS. Click here for local resources.

Click here if you are looking for support services for a family who has experienced a loss as a result of SIDS/SUID and professional publications related to SIDS.

Georgia Medicaid and Oral Health

Effective January 1, 2016, the Georgia Department of Medical Assistance Programs will adopt the AAP 2015 Bright Futures “Recommendations for Pediatric Health Care” Periodicity Schedule.  In addition, Georgia’s Medicaid EPSDT program requires that children 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.

At the 6 and 9 month visits, conduct an oral health risk assessment. Encourage the parent to select a dental home.  For the 12, 18, 24, and 30 month visits, risk assessments should continue if a dental home has not been established. Document a referral or inability to refer to a dental home if one has not been established. For those at high risk, consider application of fluoride varnish for caries prevention.  At 3 and 6 years: Determine if the patient has a dental home. If not, a referral must be made. If a dental home has not been established, perform a risk assessment.

The updated 2015 Periodicity Schedule added the subheading “Fluoride Varnish” under the “Oral Health” heading. In accordance with the US Preventive Services Task Force recommendations , once teeth are present, fluoride varnish may be applied to all children every 3 to 6 months in the primary care or dental office. Indications for fluoride use are noted in the 2014 AAP clinical report “Fluoride Use in Caries Prevention in the Primary Care Setting”.

Effective January 1, 2015, the application of topical fluoride varnish by a physician or other qualified health care professional may be billed with the new CPT code 99188. This applies to providers enrolled in and filing claims under GA Medicaid programs 430, 431, and 740.

Only providers enrolled in and filing claims under GA Medicaid programs 430, 431, 450, and 740 may bill Code D1206 Fluoride Varnish (eff. 1/1/2010).

  • Dentists: under category of service 450
  • Physicians: under category of service 430
  • Physician Assistants (PA): under category of service 431
  • Nurse Practitioners: under category of service 740

The  American Academy of Pediatrics is committed to helping pediatricians and other health providers learn how to identify oral disease, provide caries prevention services, and when to refer a to a dentist.

Pediatricians and other medical providers can play an important role in children’s oral health outcomes and improve the overall health of children. Children who may not have the opportunity to see a dentist are well served by pediatricians who are knowledgeable about 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.

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