Mississippi Administrative Code › Title 23 - Division of Medicaid › Part 223 - Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) › Chapter 1 - General › Rule 23-223-1.6 - Documentation Requirements for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Screenings

Current through June 25, 2024
A. The medical
				record must include, at a minimum, documentation of the specific age
				appropriate screening requirements according to the American Academy of
				Pediatrics (AAP) Bright Futures Periodicity Schedule including the date the
				test or procedure was performed, the specific tests or procedures performed,
				the results of the tests or procedures or an explanation of the clinical
				decision to not perform a test or procedure in accordance with the AAP Bright
				Futures Periodicity Schedule, and documentation of the following:
1. Consent for screening with the
				beneficiary's and/or legal guardian/representative's signature,
2. Beneficiary and family history with
				appropriate updates at each screening visit, including, but not limited to, the
				following:
a) Psychosocial/behavioral
				history,
b) Developmental history,
				and
c) Immunization history,
3. Measurements,
				including, but not limited to:
a)
				Length/height and weight,
b) Head
				circumference,
c) Weight for length
				percentiles,
d) Body mass index
				(BMI), and
e) Blood
				pressure,
4. Sensory
				screenings, subjective and/or objective:
a)
				Vision, and
b) Hearing,
5. Developmental/behavioral
				assessment, as appropriate, including:
a)
				Developmental screening to include, but not limited to:
1) A note indicating the date the test was
				performed,
2) The standardized tool
				used which must have:
(a) Motor, language,
				cognitive, and social-emotional developmental domains,
(b) Established reliability scores of
				approximately 0.70 or above,
(c)
				Established validity scores of approximately 0.70 or above for the tool
				conducted on a significant amount of children and using an appropriate
				standardized developmental or social-emotional assessment instrument, and
(d) Established
				sensitivity/specificity scores of approximately 0.70 or above, and
3) Evidence of a screening result
				or screening score,
b)
				Autism screening,
c) Developmental
				surveillance,
d)
				Psychosocial/behavioral assessment,
e) Tobacco, alcohol and drug use assessment,
f) Depression screening, and
g) Maternal depression screening.
6. Unclothed physical
				examination,
7. Procedures, as
				appropriate, including, but not limited to:
a) Newborn blood screening,
b) Vaccine administration, if indicated,
c) Anemia testing,
d) Lead screening and testing,
e) Tuberculin test, if indicated,
f) Dyslipidemia screening,
g) Sexually transmitted infection screening,
h) Human immunodeficiency virus
				(HIV) testing,
i) Cervical
				dysplasia screening, and
j) Other
				pertinent lab and/or medical tests, as indicated,
8. Oral health, including:
a) Dental assessment,
b) Dental counseling, and
c) Referral to a dental home at the eruption
				of the first tooth or twelve (12) months of age,
9. Anticipatory guidance, including, but not
				limited to:
a) Safety,
b) Risk reduction,
c) Nutritional assessment, and
d) Supplemental Nutrition Assistant Program
				(SNAP) and Women, Infants and Children (WIC) status,
10. Appropriate referral(s) to other enrolled
				Mississippi Medicaid providers for diagnosis and treatment,
11. Follow-up on referral(s) made to other
				enrolled Mississippi Medicaid providers for diagnosis and treatment,
12. Next scheduled EPSDT screening
				appointments, and
13. Missed
				appointments and any contacts or attempted contacts for rescheduling of EPSDT
				screening appointments.