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IHCP reminds providers lead screening is required for children

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IHCP reminds providers lead screening is required for children

The Indiana Health Coverage Programs (IHCP), in collaboration with the Indiana State Department of Health (ISDH), reminds providers that screening for blood lead toxicity is a federal requirement for all children enrolled in Medicaid.

The IHCP requires that all enrolled children receive a blood lead screening test at 9 months, 12 months, and 24 months of age. If the member is at high risk for lead exposure, the initial screening should be performed at the 6-month visit. Children between the ages of 36 months and 72 months of age must receive a blood lead screening if they have not been previously tested for lead poisoning.

The ISDH, through the Indiana Lead and Healthy Homes Program (ILHHP), monitors lead poisoning. Providers are required to report all results of blood lead screenings to the ISDH no later than one week after completing the examination. The ILHHP provides medical and environmental case management follow-up for those children who are identified with elevated levels of lead in their blood.

IHCP coverage and billing

Prior authorization is not required for coverage of screening services. Providers should see the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)/HealthWatch provider reference module for billing guidance.