Lead Screening

Lead exposure, especially among young children, continues to be a significant part of the national discussion regarding health issues. According to the Centers for Disease Control (CDC), even low levels of lead in blood have been shown to affect a child’s IQ, their ability to pay attention and academic achievement. 

Lead testing is especially vital in Philadelphia County, which is designated as a “high blood lead area.” Refer patients in Philadelphia with an abnormal blood lead level for an Environmental Lead Investigation (ELI) by completing and faxing a form to the City of Philadelphia.

DHS issued this bulletin in 2022 to inform providers enrolled in the Medical Assistance (MA) Program that they have updated the Blood Lead Reference Value to 3.5 micrograms per deciliter (μg/dL). In addition, universal blood lead toxicity testing should be completed by 12 months and at 24 months of age and is a required component of the EPSDT benefit. Providers are also required to test children between the ages of 36 and 72 months of age if they have not been previously tested for lead poisoning. Providers may test for blood lead using a capillary sample but must confirm an Elevated Blood Lead Level (EBLL) with a venous blood sample. Additionally, the MA Program provides coverage for blood lead testing of all MA enrolled children under 21 years of age at any time, if indicated by risk assessment, or for those children with a history or symptoms of lead exposure.

Our Medicaid and CHIP members are required to have a lead test completed before 12 months and at 24 months. Current CHIP policy requires that all children ages one and two years old and all children ages three through six without a prior lead blood test have blood levels screened consistent with current Department of Health and CDC standards.

If testing is not completed during these timeframes, we urge your office to perform testing at the next well-child visit.

Testing can be conducted in either your office or at a Quest Diagnostics Drawing Station. When you conduct an ‘In-Office Lab Draw’ lead screening test, please note that you should submit CPT code 83655. If the testing occurs at a Quest Diagnostics Drawing Station, be sure to provide a prescription to the parent/guardian to enable them to visit any Quest Diagnostics location. Find the closest testing facility by utilizing the provider directory and searching for “Quest Diagnostics.”

Medical treatment is not recommended for children with blood lead levels lower than 45 micrograms per deciliter, according to CDC recommendations. However, parents should learn about possible sources of lead exposure and attempt to determine if one or more sources of lead are present in their home. Parents then can follow the CDC’s recommendations to control children’s exposure to lead.

• Children can be given a blood test to measure the level of lead in their blood. These tests are covered by Medicaid and most private health insurance.
• Chelation therapy should be considered for any child that has a blood lead test result greater than or equal to 45 micrograms per deciliter.