See ICD-10-CM, page 5
AAP fact sheets explain
open enrollment, health
from the AAP Department of Community,
Chapter and State Affairs
Starting Jan. 1, 2014, almost everyone in the
United States must have health insurance or pay
a penalty under requirements of the Affordable
Care Act (ACA). Those who do not have access to
affordable coverage can begin enrolling in health
plans offered through their state’s health insurance
marketplace beginning Oct. 1.
Knowing that pediatric practices are getting
questions about the open enrollment process and
marketplaces, the Academy has created fact sheets
they can share with families to help them make
informed decisions about health insurance options.
www.aapnews.org Volume 34 • Number 10 • October 2013
In this issue
Vote: Oct. 25-Nov. 25
It is almost time to vote online for the next AAP president-elect, district
leaders and bylaws amendments. Learn more about president-elect
candidates in their discussion of the future of pediatrics. Page 7
AAP Award winners
The accomplishments of 67 individuals and one organization in child
health were honored with AAP awards. Pages 26-34
Chapters Views and News
Transition to ICD-10-CM:
one year and counting
from the AAP Division of Health Care
Finance and Practice Improvement
It appears the Centers
for Medicare & Medicaid
Services (CMS) will hold
firm to the Oct. 1, 2014,
date to transition to International Classification
of Diseases, 10th Revision, Clinical Modification
In response to a letter from the American Medical
Association and other physician groups, CMS stated
that the one-year extension from the previous transition
date of Oct. 1, 2013, gives physicians adequate time
to train their coders, complete system changeovers and
by Henry H. Bernstein, D.O., M.H.C.M., FAAP
The Academy has updated its recommendations for the prevention
and treatment of influenza in children, addressing how the influenza
vaccine composition has changed, the recent licensure
of quadrivalent vaccines, the availability of multiple
formulations of vaccine and the role of antivirals,
among other issues. The recommendations for the
2013-’ 14 influenza season are published in the October issue of Pediatrics (2013;132:e1089-e1104).
Last year’s influenza season was moderately severe
compared with the 2011-’ 12 season, with a higher
percentage of outpatient visits for influenza-like illness, higher hospitalizations rates, and more deaths
attributed to pneumonia and influenza.
As always, influenza virus is unpredictable. The
influenza season may start early in the fall/winter,
have more than one disease peak in a community
and even extend into late spring. Therefore, as soon
as the seasonal influenza vaccine is available locally,
health care personnel should be immunized, parents
and caregivers should be notified about vaccine availability, and immunization of all children 6 months
and older, especially children at high risk of complications from influenza, should begin.
Key messages from the updated policy statement
The influenza vaccine composition this
season has changed from last season.
The trivalent vaccine for the 2013-’ 14 season con-
tains the following three virus strains:
• A/California/7/2009 (H1N1)-like virus (derived
from influenza A [H1N1] pdm09 [pH1N1]
• A/Texas/50/2012 (H3N2) virus
• B/Massachusetts/2/2012-like virus (B/Yamagata
While the H1N1 antigen is the same, the influenza
A (H3N2) and B antigens differ from those in the
2012-’ 13 seasonal vaccines (two new strains).
Quadrivalent influenza vaccines
are licensed and available.
In recent years, it has proven difficult to predict
consistently which of two B virus lineages (i.e., Victoria or Yamagata) will predominate during a given
influenza season. Therefore, a quadrivalent influenza
vaccine with influenza B strains of both lineages may
offer improved protection.
New quadrivalent vaccines for the 2013-’ 14 season
contain the same three strains as the trivalent vaccine
and include an additional B strain (opposite lineage).
Post-marketing safety and vaccine effectiveness data
are not yet available, prohibiting a full risk-benefit
analysis of newer vs. previously available products.
AAP updates policy on flu prevention, treatment
See Influenza, page 4
See Open enrollment, page 13
Add-on helmet attachments, such as bumpers, pads and sensors, are
being marketed as a way to decrease the risk of concussion in young
athletes. At this time, however, there is no evidence that helmets or
third -party add-ons can prevent or reduce the severity of concussions.
See article on Page 17.
No evidence helmet attachments
prevent concussions in young athletes