MedicaidDocumentationMedium impact
20-954 Is Your Screening of Young Children's Blood Lead Levels Compliant?
Health Net·CA · Pediatrics, Family Medicine·Reimbursement
We identified it
Jun 20, 2026
Summary
This policy reinforces compliance requirements for blood lead screening in children ages 6 months to 6 years during periodic health assessments. Key requirements include mandatory screening at 12 and 24 months, specific documentation when parents refuse testing, and proper billing using CPT 83655 and ICD-10 Z13.88.
Action Required
Immediately: Billing team must ensure CPT 83655 and ICD-10 Z13.88 are used for blood lead screenings. Providers must document parental refusal with signed statements when consent is withheld, or document why signed refusal was not obtained. Update EMR templates to include lead screening reminders for children 6 months to 6 years during periodic health assessments.