Preventive Health Guidelines

Columbia United Providers (CUP) utilizes recommendations from the 2010-11 Preventive Services Task Force (USPSTF) and other sources to develop age appropriate Minimum Preventive Guidelines.  The USPSTF is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.  Other sources are noted below.

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program is a preventive health care benefit to screen members 20 years and younger in order to identify physical and/or mental health problems.  Access to services for EPSDT are required by federal rules at 42 CFR, Part 441, Subpart B.

Minimum Preventive Guidelines

• Birth to 10 Yrs Preventive Guidelines 
• 11-24 Yrs Preventive Guidelines 
• 25-64 Yrs Preventive Guidelines
• 65+ Yrs Preventive Guidelines
• EPSDT Guidelines
• Pregnant Women Preventive Guidelines

EPSDT Guidelines
At a minimum, EPSDT screenings must include, but are not limited to:

• A comprehensive health and developmental history at each screening examination
• A comprehensive physical examination performed at each screening examination
• Appropriate vision testing
• Appropriate hearing testing
• Developmental assessment
• Nutritional assessment
• Appropriate laboratory tests
• Dental/oral health assessment
• Health education and counseling
• Age appropriate mental health and substance abuse screening

EPDST Well Child Exam - Sample Forms:

• Infancy
  2-4 weeks        2 months        4 months        6 months       9 months        12 months
  
• Early Childhood
  18 months     2 years        3 years         4 years
  
• Late Childhood
  5 years       6 years     8 years     10 years     12 years
  
• Adolescence
  14 years       16 years       18 years

Sports Physicals

Teen members who are required to have a sports physical exam prior to entering any of the school athletic programs may get credit for an adolescent well care exam by utilizing the special sports physical form below. Providers will be able to bill this sports physical as an adolescent well care exam if all elements on the form are completed.  Additionally, this may increase the HEDIS® quality rating for this measure.  Be sure to make a copy for the medical record as well as the school's athletic program.

Sports Physical Form 

 Abbreviations:

AAFP                             American Academy of Family Physicians
AAP                               American Academy of Pediatrics
ACIP                             Advisory Committee on Immunization Practices
ADA                              American Diabetes Association
CDC                             Centers for Disease Control and Prevention
EPSDT                         Early Periodic Screening, Diagnosis, and Treatment
HCA                              Health Care Authority
USPSTF                      United States Preventive Services Task Force