June 2019

Infant and Early Childhood Developmental Surveillance and Screening Components of the THSteps Checkup

Blue Cross and Blue Shield of Texas (BCBSTX) conducts quarterly audits of Medicaid (STAR and STAR Kids) Texas Health Steps (THSteps) checkups, and CHIP well-child checkup records to ensure providers include the required components of a thorough exam based on a child’s age at the time of the exam.

The THSteps Periodicity Schedule for Infants, Children and Adolescents defines the required components of the checkup, and closely reflects the Bright Futures/American Academy of Pediatrics schedule of Recommendations for Preventive Pediatric Health Care.

One of the required components of the THSteps checkup is developmental surveillance. This requirement is divided into separate, but related components. The periodicity schedule is specific about the tools that practitioners should use to be compliant with the audit. Common errors that lead to non-compliance are use of an incorrect screening tool, and not performing or documenting this vital component. Remember to reference the THS Periodicity Schedule if you are uncertain about what documentation is required based on your patients’ ages.

The THS Periodicity Schedule specifically requires the following for the developmental surveillance assessment: ASQ, ASQ:SE¹, PEDS:DM and PEDS² at ages 9 months, 18 months, 24 months, 30 months, 5 years and 6 years. Please be aware that the Denver Developmental Assessment is not among the accepted formal assessments for these ages. Additionally, Autism Spectrum Disorder Assessments M-CHAT or M-CHAT-R/F^TM (available at no cost) are required at ages 18 months and 24 months. The table below further details the components.

Best Practice Summary:

1. Ensure you are following the most up-to-date THSteps Medical Checkup Periodicity Schedule for infants, children and adolescents.
2. Ensure you are using the correct screening tool for patients starting at 9 months.
3. Complete the following THSteps CME/CNE training at no cost: “Developmental Surveillance and Screening: Birth through 6 Years.”
4. Reference and review BCBSTX’s Preventive Care Guidelines and Clinical Practice Guidelines, and the Texas Health Steps for Providers website for more information on this and other important topics for treating your patients.

References:
¹ Ages & Stages Questionnaires, Paul H. Brookes Publishing Co., 2019.
² PEDS Test. PEDStest Online, 2018.