EPSDT Care for Kids Newsletter

EPSDT Care for Kids Newsletter

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Spring 2006

Testing to Identify Lead-Poisoned Children
Rita Gergely, Chief, Lead Poisoning Prevention Bureau
Iowa Department of Public Health

Test all children for lead poisoning, using a blood lead level test. Initial testing may use a capillary or venous test. Confirm any capillary blood lead level greater than or equal to 15 micrograms per deciliter (μg/dL) with a venous blood lead test.

Child at window

How frequently a child is tested depends on whether a child is at high or low risk of lead exposure. The Iowa Department of Public Health recommends using the Childhood Lead Poisoning Risk Questionnaire to determine whether a child is at high or low risk.

Low risk. If a parent answers “no” to all of the questions, the child is considered to be at low risk. In this situation, the child should be tested for lead poisoning at the ages of 12 and 24 months. If a child is older than 24 months and has not been tested, perform a lead test. Use the lead questionnaire to assess risk at each visit; if the level of risk does not change, no further testing is needed.

High risk. A parental answer of “yes” or “I don’t know” to any of the questions places the child in the high-risk category. When this occurs, test the child for lead poisoning at the ages of 12, 18, and 24 months, and 3, 4, and 5 years.

Basic Lead Testing Chart (Based on risk and age)
RISK CLASSIFICATION as determined by risk questionnaire
Low risk: Test at ages of		High risk: Test at ages of
12 and 24 months		12 months 18 months 24 months 3 years 4 years 5 years
If older than 24 months and no previous test, test once
Continue to assess risk
No additional testing needed if risk does not change

The Iowa Department of Human Services recommendations for the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program follow this schedule. Federal law requires lead testing of children enrolled in Medicaid, Head Start, and WIC.

For additional information about testing children for lead poisoning, contact the IDPH Bureau of Lead Poisoning Prevention at 1-800-972-2026.

How do I bill for… Lead Testing

For lead testing services, bill code 99000 in addition to using the other codes appropriate to the services provided in the Care for Kids exam. The confirmatory draw would also use the code of 99000, with the appropriate E&M code. After confirming lead poisoning, treatment services use the ICD9 code for lead poisoning, which is 984.0.

Resources

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