Breaking News · American Academy of

Pediatrics backs new ACIP

recommendation on influenza vaccine

Summer Newsletter

July 15, 2016

Inside this issue:

Fluoride Varnish

application 2

Billing training 3

Bright Futures

Periodicity Schedule 4

CHDP Electronic

PM160 5

Summer Camps 6

Overnight Summer

Camps 7

Tuberculosis

documentation 8

Zika Virus 9

Recertification of

provider sites 10

New recommendations from American Academy of Pediatrics regarding

the live attenuated influenza vaccine released on Wednesday, June 22,

2016 state the following: Health care providers should not use live atten-

uated influenza vaccine (LAIV) in the upcoming 2016-'17 season due to

poor effectiveness, a Centers for Disease Control and Prevention (CDC)

committee said Wednesday.

Academy leaders say they support the interim recommendation by the

CDC's Advisory Committee on Immunization Practices (ACIP).

"We agree with ACIP's decision today to recommend health care provid-

ers and parents use only the inactivated vaccine for this influenza sea-

son," said AAP President Benard Dreyer, M.D., FAAP.

The AAP recommends children ages 6 months and older be immunized

against influenza every year. Previously, the CDC and AAP had recom-

mended either form of flu vaccine – the inactivated influenza vaccine

(IIV) that is given by injection and is approved for all patients older than

6 months, or LAIV which is given by intranasal spray and is approved for

healthy patients ages 2 through 49 years.

However, new data presented to the ACIP showed that currently only IIV

provides protection against flu. The ACIP assessed data from the past

three influenza seasons and cited evidence of poor effectiveness of LAIV

during this time period.

“We do understand this change will be difficult for pediatric practices

who were planning to give the intranasal spray to their patients, and to

patients who prefer that route of administration,” said AAP CEO/

Executive Director Karen Remley, M.D., M.B.A., M.P.H., FAAP.

"However the science is compelling that the inactivated vaccine is the

best way to protect children from what can be an unpredictable and dan-

gerous virus. The AAP will be working with CDC and vaccine manufac-

turers to make sure pediatricians and families have access to appropriate

vaccines, and to help pediatricians who have already ordered intranasal

vaccines."

For more information regarding influenza vaccine please go to aapnews.org

Rates of Dental Decay in Preschool

Children Decline as Fluoride Varnish

Applications (FVA) Soar in North County

Page 2

One could say there is

real cause for alarm at

the numbers of children

in Santa Barbara Coun-

ty entering State pre-

school with untreated

dental decay over the

last 10 years. In the bar

graph, Santa Maria

(shown in blue) initially

had higher rates of den-

tal disease than their

Santa Barbara counter-

parts, but then some-

thing happened. About

6 years ago the rates

of dental decay in Santa Maria started trending

downward .

If you are wondering what has made the difference in

North County, the answer is fluoridation of drinking

water and regular application of fluoride varnish.

Making fluoride varnish application a routine part of

well child visits has played an important role in the

oral health outcomes of young children in North

County, where the majority of fluoride application are

taking place.

Santa Barbara County CHDP would like to congratu-

late and thank the CHDP Providers in the North

County for their diligence in providing this service. It

is our goal to encourage this practice throughout the

County to improve the dental health of all of our cli-

ents. For more information on how to incorporate flu-

oride varnish into your practice, please contact CHDP

Public Health Nurse, Joyce Rara, at (805) 681-5122 or

Joyce.Rara@sbcphd.org.

Fluoride varnish application by medical provider,

Santa Barbara county region

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Page 3

Billing for Fluoride Varnish:

Use HCPCS code D1206 (topical application of fluoride child).

Benefit is limited to children age 0 to 5.

Reimbursement for D1206 includes all materials and supplies

needed for the application.

Applications must be documented in the member’s medical record.

Treatment is covered up to 3 times in a 12-month period.

Physicians, FQHCs, Clinics, and Hospitals providing outpatient

services may bill for the service.

A Reminder from CenCal !

Billing for Fluoride Varnish

For questions regarding claims and billing, please contact CenCal Claims Department at 805.562.1083.

For any other questions, please contact the Provider Services Department at 805.562.1676

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Effective for dates of service on or after July 1, 2016, the American Acad-emy of Pediatrics (AAP) Bright Futures periodicity schedule for fee-for service, well child health assessments is implemented for CHDP. See both the CHDP Bright Futures Schedule for Health Assessments by Age Groups and CHDP/EPSDT Periodicity Schedule for Dental Referral by Age PDFs for guidelines.

The information on the health assessment periodicity schedule being re-leased supersedes the CHDP Periodicity Schedule for Health Assessment Requirements by Age Groups on the Medi-Cal website and in the Appen-dix of the CHDP provider manual, which will be updated later. The infor-mation on the dental periodicity schedule being released supersedes any dental periodicity schedule dated prior to 2016.

Under the Bright Futures health assessment periodicity schedule, 14 ad-ditional health assessments will be added to the 15 health assessments presently reimbursable for children and youth from birth to age 21.

Claims for the additional assessments shown below should be billed as

Medically Necessary Interperiodic Health Assessments (MNIHAs) on the

CHDP Confidential Screening/Billing Report (PM 160) claim form.

To bill one of the 14 health assessments, providers should en-ter the following in the Comments/Problems area of the claim:

MNIHA: There is a need to complete health assessment requirements

This policy will be released in the provider manual in a future

CHDP Update bulletin. Clink here for the full link Click here to view

Bright Futures

Periodicity table

Page 4

CHDP Implements Bright futures

periodicity Schedule

CHDP Claims

Payment Carve-In

To CenCal and

Electronic

PM160

Effective July 1, 2016,

CenCal Health will begin

administering payment for

CHDP services for all Cen-

Cal Health members. A

vendor, eCHDP, has been

selected to streamline the

entry and submission of

claims and PM160 data

through an online solu-

tion. All offices that see

CHDP clients with CenCal

will need to sign up and

create an account on

eCHDP’s website: https://

signup.pm160form.com.

Data entry and submis-

sions of PM160 forms may

be completed through

eCHDP using their online

software.

Providers can submit pa-

per PM 160 for CenCal

Health members. (See

Flowsheet )

For clients who have State

Medi-Cal or Gateway, pa-

per PM 160s needs to be

submitted to State Medi-

Cal . (See Flowsheet)

Page 5

Paper PM160 Submission

For CenCal Members

Paper PM160 Submission For

State Medi-Cal / Gateway

For clients who have State Medi-Cal or Gateway, paper PM

160s can be submitted to State Medi-Cal directly by :

1. Mailing directly to State Medi-Cal

2. Printing the PM 160 through eCHDP and mailing it to

State Medi-Cal (requires eCHDP software)

3. Submitting PM 160 electronically from eCHDP software

to State Medi-Cal (requires DHCS 4431 Application; this

process will take time.)

Keep copy of

PM 160

in chart

Paper PM 160s will

be mailed to eCHDP:

P.O. Box 53250

Irvine, CA 92619

Claims correction will be completed by

calling CenCal Health’s Provider Services

at (805) 685-9525

No need to send

a copy to the

local CHDP

office

Give a copy of

form (PINK) to

the parent

Give a copy of

form (PINK) to

the parent

Claims correction will be sent to Xerox:

P.O. Box 15300 Sacramento, CA 95851

Send a copy

(YELLOW) to the

local CHDP

office

Paper PM 160s will

be sent to State

Medi-Cal/ CHDP:

P.O. Box 15300 Sac-

ramento, CA 95851

Keep copy of PM

160 in chart

Summer camp can be a wonderful experience for all children, giving them the opportunity to

experience nature, build relationships, learn new skills and have fun. Many children with spe-

cial needs are able to attend regular camps; others can benefit from being with children with

similar needs and still others are unable to attend camp without special medical attention. Be-

low is a list of some camps in Southern California (unless otherwise indicated) that are for chil-

dren with specific conditions. Information about these and other camps is available on the in-

ternet at www.sbsnap.org, www.acacamps.org, http://specialcampsforspecialkids.com/ or

through agencies that serve children with particular diagnoses. Low-income South Coast fami-

lies can contact the Santa Barbara Campership Alliance at 962-5560 for help with finding local

camp scholarships. Tri-Counties Regional Center clients can contact their service coordinators

for possible assistance. Financial assistance may also be available via Native Daughters of the

Golden West Childrens Foundation: 800-994-6349. Angel Flight www.angelflight.org,

(888-4-ANANGEL) can sometimes assist with transportation in certain circumstances.

Table 1 informs you of three camps avail-

able in Santa Barbara area. Contact the

City Recreation Departments at Lompoc:

875-8100, Santa Barbara: 564-5421, San-

ta Maria: 925-0951, x260 for information

about camps that can accommodate chil-

dren with special needs; also check with

local YMCAs, Boys & Girls Clubs, colleg-

es, Scouts, museums, churches and

www.sbparent.com camp directory for

camp information. Another excellent re-

source for activities for children with spe-

cial needs (bike camp, etc.) is,

www.sbsnap.org

2016 Summer Camps

Page 6

A picture of two counselors http://thepaintedturtle.org/

Dates 2016 Location Camp Specialty

July 11-14 UCSB Junior

Wheelchair

Sports

Physical

Disabilities

July 25-29

Or

August 1-5

Santa

Barbara

Happy

Adventure

Summer

Camp

Severe De-

velopmental

Disabilities

Ages 5 and

up

August 8-12 Santa

Barbara

Camp

Wheeze

Asthma

Day Camp 2016

Table 1

Page 7

Overnight camp 2016

Table 2 below will inform you of 9 overnight camps along with phone numbers and extensions.

Specialty Camp Name Website Phone #

Arthritis Camp Esperanza at

The Painted Turtle

Email: aavishai@arthritis.org (602) 212-9905

Cancer Camp Ronald McDon-

ald for Good Times http://rmhcsc.org/camp/ (310) 268-8488

Chronic or se-

rious Illnesses/

Disabilities

Dream Street Camps https://dreamstreetfoundation.org/ (424) 333-1371

Diabetes Camp Conrad—

Chinock

http://www.diabetescamping.org/ (661) 724-1550

Heart Disease Camp del Corazon http://www.campdelcorazon.org/ (310) 751-3057

HIV/Aids Camp Laurel http://www.laurel-foundation.org/ (818) 754-0312

Muscular

Dystrophy

MDA Camp https://www.mda.org/ (310) 390-6802

Physical

Developmen-

tal Disabilities

Ability First Camp

Easter Seals Camp

Harmon

http://camppaivika.org/

Easter Seals Central California |

Camp Harmon

(909) 338-1102

Ext. 5004

831-338-3383

Visual

Impairments

Camp Bloomfield

In Malibu

https://www.juniorblind.org/ (323) 295-4555

Ext. 272

Tuberculosis (TB) Infection is a serious disease

caused by Mycobacterium tuberculosis bacteria. It spreads

from person to person through air. TB mainly affects the

lungs, but can also affect other organs like kidneys, bones

and brain. There are two related conditions: Latent TB in-

fection (LTBI) and TB disease. LTBI is not contagious, but

a person with LTBI should take medication to prevent de-

velopment of disease. TB disease will make an individual

sick as well as contagious to others, so it is important that

people with TB are treated. For more information please visit CDC link http://www.cdc.gov/tb/

Per CHDP Health Assessment

Guidelines, the risk of expo-

sure to tuberculosis must

be assessed at each Health

Assessment visit using a

Pediatric TB Risk Assess-

ment Questionnaire.

Results from questionnaire

must be clearly documented in

the patient’s medical record as

both CenCal and CHDP look

for this documentation when

performing a Medical Record

Review during a site audit.

More information about TB risk

assessment is available at

11-04 PIN section 73-7.

Tuberculosis Risk assessment Questionnaire

http://www.bchdmi.org/cchs/tb

Page 8

ZiKa virus What is New?

The Mosquito and Vector Management District is actively monitoring for Aedes

species (A. aegypti and A. albopictus). This mosquito has not been found in San-

ta Barbara County although it is known to be present in 12 other California

counties, including Los Angeles County and Kern County. There is no evidence

to suggest that the Aedes mosquitoes in any area of California are carrying the

Zika virus. Heightened surveillance and testing of mosquitoes is ongoing across

the state. For the latest information regarding Zika Virus please visit CDC.gov

http://wwwnc.cdc.gov/travel/page/zika-travel-information

Page 9

Children’s Medical Clinic of

Santa Barbara

Website:

www.childrenssb.com/

Community Health Center

Guadalupe

Website:

CHC Clinics Website

Dignity Family Medicine

Center

Website:

www.dignityhealth.org/

Central Coast Family Care

Website:

www.ccfcmedical.com

Santa Ynez Tribal Health

Clinic

Website:

www.sythc.com

American Indian Health and

Website:

www.aihscorp.org

Re-Certified CHDP Provider Sites

Services

Page 10