MedicaidDocumentationMedium impact
Screen Medicaid Members for Lead Exposure Before Their Second Birthday
BCBS Illinois·IL · Pediatrics, Family Medicine·Government Programs
Effective date
May 21, 2026
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield of Illinois now requires blood lead screening for all Medicaid children at 12 and 24 months of age, with catch-up testing for children 24-72 months old who have never been screened. Proper documentation and specific CPT/ICD-10 coding is required for compliance with quality measures.
Action Required
By May 21, 2026: Billing team must update encounter forms and EMR templates to include lead screening reminders for Medicaid children at 12 and 24-month well-child visits. Ensure staff use CPT 83655 for blood lead analysis, CPT 36415 for venipuncture collection, CPT 36416 for capillary collection, and ICD-10-CM R78.71 for abnormal lead levels. Providers must document all screening results in medical records for quality measure compliance.