< Back Official AAP Letters on Practice Issues This is a collection of official letters from the American Academy of Pediatrics about important pediatric practice issues, including providing information to carriers about new vaccine codes and ensuring proper understanding, interpretation and use of the Current Procedural Terminology (CPT) work of medical nomenclature. Find more Documents & Forms in the Practice Toolbox AAP Letter: AAP Notifies National Payers Regarding Increase in Vaccine Costs Official AAP letter to the national payers, dated February 11, 2009, urging payers to increase payments to correspond with the vaccine cost increases noting that pediatricians cannot be expected to absorb the cost increases while waiting several months for carriers to update their fee schedules. AAP Letter: AAP objects to influenza immunization as HEDIS measure Official AAP letter to the National Committee on Quality Assurance (NCQA), dated November 25, 2008, urging the NCQA to reconsider its intent to incorporate influenza immunizations as a Healthcare Effectiveness Data Information Set (HEDIS) measure beginning 2010. AAP Letter: AAP Notifies National Payers Regarding Developmental Screenings Official AAP letter to national payers, dated November 3, 2008, clarifies the recommendations for autism and developmental screening and urges carrier coverage and payment for screenings reported using CPT code 96110. AAP Letter: AAP Encourages Payers to Update Their Claims Systems for Recognition of the Revised Code Numbers Official AAP letter to national payers, dated October 23, 2008, to encourage payers to update their claims systems for recognition of the revised code numbers before January 1, 2009. AAP Letter: AAP Notifies National Payers on Assistive Technology Official AAP letter to national payers, dated August 29, 2008, notified national carriers, benefit plan consultants and business groups on health informing them of the AAP clinical report Prescribing Assistive-Technology Systems. AAP Letter: AAP Notified National Carriers of the Prevnar® Price Increase Official AAP letter to national payers, dated August 13, 2008, notified national carriers of the Prevnar® price increase and urged payers to update their payments in a more timely fashion. AAP Letter: AAP Notified National Carriers about the Business Case for Breastfeeding Official AAP letter to national payers, dated July 25, 2008, notified national carriers about initiatives to promote employer support of breatfeeding women. It describes two groups that advocate for insurance coverage of and payment for breastfeeding-related services and equipment in support of the recommendation that infants be exclusively breastfed through the first six months. AAP Letter: UnitedHealthcare Regarding Apnea Monitoring Official AAP letter to UnitedHealthcare, dated February 26, 2008, objecting to the carrier's coverage policy for home apnea monitoring for infants and its provisions for terminating monitoring. AAP Letter: Merck Price Increase for Vaccines Official AAP letter to medical directors, dated February 13, 2008, notifying national carriers of the increase in the price of Merck vaccines. The letter urged payers to update their fee schedules immediately to reflect the increase costs to pediatricians. AAP Letter: Hib Vaccine Supply Disruption and Revised Recommendations Official AAP letter to medical directors, dated January 30, 2008, notifying of the revised recommendations for Hib vaccines as a result of supply disruptions. The letter also advocated for pay for performance measures to account for factors outside of the physicians control, such as disruptions in vaccine availability. AAP Letter: Payers Notified of Recommendations for Live, Attenuated Influenza Vaccine (LAIV) Official AAP letter to medical directors, dated December 20, 2007, notifying national carriers of the recent expansion of the recommendations by the Advisory Committee on Immunization Practices (ACIP) for the use of the live, attenuated influenza vaccine (LAIV) to include children 2 to 4 years of age. AAP Letter: Inappropriate Bundling of Preventive and Problem-Oriented Evaluation and Management (E/M) Visits Official AAP letter to national carriers and all Blue Cross Blue Shield Plans, dated September 27, 2007. The AAP joined with several other specialty societies in this letter to carriers advocating for payment for preventive and problem-oriented evaluation and management (E/M) visits reported for the same patient on the same day. AAP Letter: AAP Responds to Coventry Health Care, Inc. This letter, dated September 19, 2007, urges Coventry Health Care, Inc. to provide adequate payment to physicians for vaccines. AAP Letter: AAP Responds to Carriers Regarding EHRs and Electronic Prescribing This letter, dated August 28, 2007, urges payers to support systems to include functions relevant to the pediatric patient. AAP Letter: Timely Updating of Claims Adjudication Systems for Prevnar Price Increase Official AAP letter to health plan medical directors, dated August 15, 2007, encouraging timely updates to claims adjudication systems to cover the August 2007 price increase of Prevnar. AAP Letter: AAP Responds to Great-West on Vaccine Payments This letter to Great-West is in response to their letter responding to AAP's first communication with them regarding inadequate vaccine payment. It specifically addresses vaccines as a cost center. AAP Letter: Appropriate Payment for Vaccines and Immunization Administration (Great-West Healthcare) Official AAP letter to Great-West Healthcare, dated April 2, 2007, providing background and rationale for adequate payment for immunizations. AAP Letter: Appropriate Payment for Vaccines and Immunization Administration (Excellus Blue Cross Blue Shield) Official AAP letter to Excellus Blue Cross Blue Shield, dated March 19, 2007, providing background and rationale for adequate payment for immunizations. AAP Letter: Developmental Screening and Testing A letter written by the AAP to insurance carriers in March 2007 providing background and rationale for covering all required developmental screening procedures. AAP Letter: Notice of Sanofi Pasteur Price Increases Official AAP letter to health plan medical directors, dated December 21, 2006, providing an update on price increases as reported by sanofi pasteur and encouraging payers to adjust their payments to pediatricians appropriately. AAP Letter: Increased Costs for the Conjugated Pneumococcal Vaccine Official AAP letter to health plan medical directors, dated September 9, 2005, encouraging them to ensure that their claims adjudication systems are updated in a timely manner to cover the increased costs for the conjugated pneumococcal vaccine (PCV7 or Prevnar). AAP Letter: Proquad (Measles, Mumps, Rubella, and Varicella) September 2005 letter from Carol Berkowitz, MD, FAAP, providing advanced notice to carriers regarding the recent USDA approval of the combination vaccine for measles, mumps, rubella, and varicella (Proquad). AAP Letter: MCV4 (or Menactra) and Prompt and Adequate Payment April 2005 letter from Carol Berkowitz, MD, FAAP, providing advanced notice to carriers regarding the newly licensed meningococcal conjugate vaccine (MCV4 or Menactra) and encouraging prompt and adequate payment. AAP Letter: Pediatric Immunization Administration Codes Official AAP letter to health plan medical directors, dated December 23, 2004, to inform carriers about impending changes affecting immunization administration codes and their relative values. AAP Letter: Appropriate Coding of the Initial Newborn Visit Official AAP letter to health plan medical directors, dated December 8, 2004, in regards to concerns about the appropriate coding of the initial newborn visit at 2-4 days of age. AAP Letter: Appropriate Coverage and Compensation for the Conjugated Pneumococcal Vaccine Official AAP letter to health plan CEOs and medical directors, dated October 6, 2004, encouraging them to ensure appropriate coverage and compensation for the conjugated pneumococcal vaccine (PCV7 or Prevnar) in light of resumption of recommended dosages and increased costs. AAP Letter: Testimony before the National Committee on Vital and Health Statistics Subcommittee on Privacy and Confidentiality Official AAP testimony to the National Committee on Vital and Health Statistics Subcommittee on Privacy and Confidentiality, dated February 19, 2004, to inform the subcommittee about concerns that the implementation of the HIPAA Privacy Rule has resulted in significant problems for school health personnel and the students and families they serve. AAP Letter: Code for Preservative-Free Influenza Vaccine Official AAP letter to health plan medical directors, dated October 10, 2003, to inform carriers about the early release of 90655, a new code for preservative-free influenza vaccine provided to children aged 6-35 months. AAP Letter: Linking E/M Codes September 2003 letter from E. Stephen Edwards, MD, FAAP, regarding carriers' practice of determining the suitability of a reported CPT code based on the ICD-9-CM code(s) used in describing the reason for an evaluation and management visit. AAP Letter: The Proper Use of CPT Codes (CIGNA) Official AAP letter to CIGNA Corporation, dated November 8, 2002, in regards to concerns about the proper understanding, interpretation, and use of the current procedural terminology (CPT) work of medical nomenclature. AAP Letter: The Proper Use of CPT Codes (Aetna) Official AAP letter to Aetna, Inc., dated October 16, 2002, in regards to concerns about the proper understanding, interpretation, and use of the current procedural terminology (CPT) work of medical nomenclature. AAP Letter: Contract Issues and the Proper Use of CPT Codes (Anthem) Official AAP letter to Anthem, Inc., dated July 11, 2002, in regards to concerns about the proper understanding, interpretation, and use of the current procedural terminology (CPT) work of medical nomenclature and concerns about a specific provision of Anthem's Professional Provider Agreement. AAP Letter: Health Insurance Reform: National Standard Health Care Provider Identifier; Proposed Rule Official AAP letter to the Health Care Financing Administration, U.S. Department of Health and Human Services, dated June 29, 1998, to provide AAP comments on the proposed rule for the National Provider Identifier (NPI) standard.