Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Public Programs)
Child and Teen
Checkups
Child and teen checkups (C&TC) are comprehensive preventive
care services provided to children under the age of 21 enrolled in a
public program. These services are usually performed at the
primary care clinic (PCC). They may also be performed by a
public health nurse clinic in the referral network without a referral
from the PCC.
Child and teen checkups can be identified by procedure code
S0302 on a claim or on another claim with the same date of
service. Since these checkups involve additional time spent with
the patient, this code allows the provider to charge a “bump-up”
amount for performing the C&TC.
Covered Services
Anticipatory guidance and health education
Assessment of physical growth and measurements
Health history including mental health, nutrition, and chemical
use
Developmental/behavioral assessments
Physical examination including sexual development, oral exam
Immunizations/review
Laboratory tests including blood lead, urinalysis,
hemoglobin/hematocrit and other tests as indicated
Vision screening
Hearing screening
Dental checkups - verbal referral for preventive dental care
Diagnosis and treatment of health conditions listed in the
Minnesota Health Care Programs (MHCP) benefit plan and
others determined to be medically necessary, are also covered
services.
C&TC Component Commonly Billed Code(s) Notes
Anticipatory
Guidance and health
education
Measurement –
height, weight, head
circumference, blood
pressure
11-2
99401-99404 This component may be billed separately
only if at least 15 minutes is spent
specifically on this topic.
Not billed separately, part
of the E&M
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (02/07/12)