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Lead toxicity screening is required for all Apple Health-enrolled children age 12
months and 24 months, regardless of lead exposure risk.
This is not a new requirement.
This is a clarification of an existing requirement of the Centers for Medicare
and Medicaid Services (CMS).
Washington State has requested a waiver
from CMS to change from the current requirement of universal screening to
targeted screening for children most at risk for elevated blood lead levels. Until
CMS approves or denies that request, providers must follow CMS guidelines and
screen all children at the required ages.
The required testing for blood lead
poisoning in children should be billed using CPT code 83655. Either of the
following diagnosis codes may be used:
- Z77.011
contact with and (suspected) exposure to lead
OR
- Z13.88 special screening for other
conditions, chemical poisoning, and other contamination
For additional information regarding
screening in children, see the Early Periodic
Screening, Diagnosis and Treatment (EPSDT) Program Provider Guide.
CPT® codes and descriptions are copyright 2015 American
Medical Association.
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