Evidence suggests that many children are not identified with developmental delays until they begin school. Children insured by Medicaid are twice as likely to be at risk for developmental delays. Other risk factors include pre-term birth, low birth weight, and prenatal alcohol or drug exposure.
The American Academy of Pediatrics (AAP) recommends routine screening with a standardized developmental screening tool at nine, 18, and 30 months to identify areas of a child’s development that differ from age-specific norms.
Developmental surveillance should also be completed at every provider visit to monitor children who may be at risk for developmental delays.
Best Practices for Developmental Screening
Use of Evidence-Based Developmental Screening Tools
Evidence-based developmental screening tools, such as the Ages & Stages Questionnaires® (ASQ), provide reliable, accurate developmental and social-emotional screening for children. If the parent or guardian can complete the screening tool prior to the appointment then more time can be spent on discussing the responses and reviewing a development plan, if needed. Implement office procedures that allows for the screening tool to be completed prior to the scheduled appointment, such as:
- Mail a paper copy of the screening to the member’s parent or guardian so that it can be completed prior to the scheduled appointment
- When confirming the appointment via email, phone, or patient portal, provide a link to complete an online version of the screening tool
- For those that do not complete the paper or online screening tool ahead of the scheduled appointment, provide them with a tablet or paper form to fill out while in the waiting room
Find additional developmental screening tools and other resources recommended by the AAP to support effective management of early childhood development.
Pre-visit Planning
Coordinate with social workers or case managers to call ahead to remind the family about the scheduled appointment, assist with any transportation or other needs, and then conduct brief screenings, including a developmental screening.
In-office Screening Process Workflow
Create a screening process workflow that works best for all staff within the office for all screenings, or for those patients who did not return a completed screening form to the appointment. Each provider office is unique, there isn’t a “one size fits all” process, but the following tools are available to help establish a screening process workflow that will work best for your practice:
AAP – Getting Started: Implementing a Screening Process
AAP – Improving Developmental Screening and Follow-up: Comprehensive Quality Improvement Toolkit
Autism Screening
The prevalence of autism spectrum disorders (ASDs) in 11 surveillance states was 2 in 59 children aged 8 years in 2014. (Baio, MMWR 2018; AAP 2007)
The AAP recommends formal autism screening with a validated autism-specific tool at 18 and 24 months to monitor for developmental regression.
Developmental and Autism Specific Screening Coding
To effectively track global developmental and autism-specific screenings, NYS requests that providers bill to the following CPT codes:
- 96110 code for global developmental screening with a standardized screening tool
- 96110 with CG modifier for autism-specific screening with a standardized screening tool
