Childhood Blood Lead Level Screening Requirements
The Department of Health Care Services (DHCS) requires that all providers who conduct periodic health assessments on Medi-Cal children provide the following:
- Verbal or written anticipatory guidance to child's legal parent or guardian of the harmful effects of lead exposure for children starting at ages six months to 72 months (6 years). At a minimum, the information should include that:
- Children can be harmed by lead exposure from old or chipping lead-based paint and dust.
- Children that begin to crawl until 72 months of age, are particularly at risk.
- Blood lead level testing (finger stick or venous blood draw) on children:
- At 12 months and 24 months of age.
- If child between ages 12-24 months have no record of lead testing.
- If child between ages 24-72 months is missing a lead test at 24 months or after.
- When requested by child's parent or guardian.
- When provider conducting Periodic Health Assessment (PHA) for child 12-72 months is aware of increased risk of lead exposure/poisoning due to changes in child's circumstances.
Providers must follow the California Department of Public Health Guidelines (PDF) for interpreting blood lead levels and follow-up activities for elevated blood lead levels.
- Screening for elevated blood levels can be conducted by finger stick test or via venous blood draw.
- Confirming or retesting of blood lead levels should be conducted through the venous blood test.
Tools to help you complete lead screenings
California Health & Wellness provides the following tools to help providers identify children who need a lead test.
- Electronic care gap reports by email
- Cozeva web-based care gap reports (PDF)
If you are not receiving your care gap reports, reach out to your provider representative for information on obtaining or how to review these reports.
Submit codes as evidence of lead testing
Providers can use the following codes for submitting claims/encounters as evidence for lead testing:
CPT Copyright 2017 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.
|Venous blood collection||CPT 36415|
|Capillary blood collection||CPT 36416|
|Lead test||CPT 83655|
|Abnormal lead level in blood||ICD-10 R78.71|
|Toxic effect of lead and its compounds, accidental (unintentional), initial encounter||ICD-10 T56.0X1A|
|Toxic effect of lead and its compounds, accidental (unintentional), subsequent encounter||ICD-10 T56.0X1D|
|Toxic effect of lead and its compounds, accidental (unintentional), sequela||ICD-10 T56.0X1S|
|Encounter for routine child health examination without abnormal findings||ICD-10 Z00.129|
|Encounter for screening for disorder due to exposure to contaminants||ICD-10 Z13.88|
|Contact with and (suspected) exposure to lead||ICD-10 Z77.011|
Providers and labs must report all lead test results to the Childhood Lead Poisoning Prevention Branch (CLPPB). Contact EBLRSupport@cdph.ca.gov.
Exceptions to providing a lead screening
Providers are not required to perform lead screening if:
- Legal parent/guardian refuses the lead screening and signs a voluntary refusal statement
- In provider's professional judgement, lead testing poses greater risk for child than lead poisoning
Providers must document reasons for not providing the lead screening or not obtaining the voluntary refusal statement in the child's medical record.
Education you can share with your patients
- Krames/CHW: The Dangers of Lead Poisoning – English
- Krames/CHW: The Dangers of Lead Poisoning – En Español (Spanish)
- Krames/CHW: Lead Poisoning: Test Your Home and Family – English
- Krames/CHW: Lead Poisoning: Test Your Home and Family – En Español (Spanish)
Additional information on Lead Screening Requirements for Medi-Cal Patients
California Health & Wellness Provider News:
- 22-249 – Tips for Childhood Blood Lead Screening – English (PDF)
- 20-955 – Is Your Screening of Young Children's Blood Lead Levels Compliant?
Department of Health Care Services: APL 20-016 Blood Lead Screening of Young Children – English (PDF)