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Health Check Program Guide

NC Medicaid Health Check Program Guide Revised 1 NC Health Check Early Preventive Screening Program Guide Table of Contents Section I: Health Check Overview ..3 Well-Child Preventive Services ..3 NC Health Check Preventive Health Services Periodicity Schedule ..4 The Bright Futures Recommendations for Preventive Pediatric Health Care Periodicity Schedule 4 NC Periodicity Schedule Quick View ..5 Section II: Periodic NC Health Check Preventive Services Visit Components .. 11 Comprehensive Health History .. 11 Unclothed Physical Assessment and Measurements .. 11 Nutritional Assessment .. 12 Vision Screenings .. 13 Hearing 14 Dental Screenings .. 16 North Carolina Oral Health Periodicity Schedule .. 18 Immunizations .. 22 Laboratory Procedures.

96127/ EP for Emotional/Behavioral screens, including ASQ-SE, PSC/SDQ/PSQ-A/eck’s, RAFFT , Vanderbilt, Conners. When 96160/EP or 96161/EP are billed with CPT code 96127/EP, modifier 59 must be appended to 96160/96161. For beneficiaries > 11 years old AAP recommends following screens (included EP modifier):

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