Required Lead Screenings
Reminder: Providers must perform lead screenings for all children enrolled in Medicaid. This is a federal requirement.
Children must receive screening tests for blood lead toxicity at nine, 12 and 24 months of age. If they have not been previously tested for lead poisoning, kids between 36 and 72 months of age must receive blood lead screenings as well. The Family and Social Services Administration (FSSA) requires that all children enrolled under Medicaid receive a blood lead screening test at 12 months and 24 months of age. If the member is at high risk for lead exposure at the 6-month visit or the 9-month visit, a screening should be performed earlier. Children between the ages of 36 months and 72 months of age must receive a blood lead screening if they have not been previously tested for lead poisoning. A blood lead test result equal to or greater than 5 ug/dl obtained by capillary specimen (fingerstick) must be confirmed using a venous blood sample. Subsequent screenings are required for at-risk patients.
Providers are required to report all results of blood lead tests to the Indiana State Department of Health (ISDH) no later than one week after the screening.
Prior authorization is not required for coverage of screening. For billing recommendations, providers should turn to this reference guide. And for more information on lead poisoning and blood lead screenings, MHS has free brochures that providers can give to their patients. Contact your Provider Relations Representative to request brochures.