July 26, 2017

From Laurie Theodorou, LCSW, Early Childhood Mental Health Policy Specialist, Oregon Health Authority, Health Systems Division, Child and Family Behavioral Health

Intervening Early Can Help

A person’s physical, social, emotional, adaptive, linguistic, and cognitive health is greatly influenced by their early life experiences. Early childhood trauma or neglect can cause lifelong negative effects on psychological functioning, academic progress, and physical health. Intervening early can accordingly help over the long term.

The Health Evidence Review Commission and The Oregon Health Authority recognize research that shows that, no matter the person’s age, providing therapeutic services as soon as possible after neglect or abuse has been identified reduces long-term suffering and medical costs for the affected client.

It is important to note:

  • Infants and young children do experience serious social/emotional or behavioral problems.
  • Children under six years can be accurately assessed and effectively treated.
  • The Oregon Health Plan will reimburse for behavioral/mental health services for children under three years.
  • Treatment for children under age 6 should include their caregiver(s).

Important Billing Codes

Special Abuse and Neglect billing codes:

For those children who qualify for Medicaid, a new line was created on the Oregon Prioritized List of Health Services or medical and behavioral health services to address abuse and neglect (download a PDF of the prioritized list here and see line 125 – Diagnoses Z 69.010-Z69.020). Codes on this line may be billed as a primary diagnosis and are without any age restrictions. Other codes are available when traumatic events occur such as loss of a parent through death or separation.

These billing codes enable early treatment:

  • Foster children, based on their history of abuse or neglect, can receive behavioral health services before they develop serious symptoms of depression, anxiety, or PTSD.
  • Children birth to five years can receive therapeutic interventions with their caregiver(s) to improve bonding and emotional regulation, reduce anxiety, and increase their readiness to learn.
  • Intervening early, when there has been abuse and neglect, is critical in preventing or lessening future physical and behavioral health issues.

For more information, contact the Coordinated Care Organization (CCO) serving the child and family. Guidance regarding how to crosswalk early childhood diagnoses with the DSM-5 criteria can be found by clicking here and opening “Oregon Early Childhood Diagnostic Crosswalk – NEW.”