MedicaidDocumentationMedium impact
20-953 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
Health Net Medi-Cal requires blood lead screening tests for children 6 months to 6 years during periodic health assessments, with mandatory documentation of parental refusals. Providers must use specific billing codes and report results to California's Childhood Lead Poisoning Prevention Branch.
Action Required
Immediately: Billing team must ensure CPT 83655 and ICD-10 Z13.88 are available for blood lead screening. Providers must document parental refusals with signed statements or reasons for not obtaining signatures in medical records. Clinical staff must add reminders to EMR templates for required lead screenings at 12 and 24 months, and guidance provision at each PHA from 6-72 months.