Lead Screening in Children (LSC)
Based on current NCQA HEDIS and the State of New Jersey recommendations, your TO-DO List for pediatric patients should include:
- Medicaid Members – Order a capillary or venous lead blood test by the child’s 1st birthday and again by the child’s 2nd birthday
Why should you complete your TO-DO LIST?
It is an evidence-based, best practice and these actions are used to measure your quality performance.
Population Defined for Lead Screening in Children
(NCQA HEDIS guidelines, Measurement Year (MY) 2022)
- Members who turn 2 years of age during the measurement year
- Line of Business: Medicaid
The following is based on the State of New Jersey’s recommendations:
|Required testing by the State of New Jersey at 12 and 24 months of age.
Providers will have a compliance rate of greater than 80% for two consecutive six months periods for lead level tests
|Perform capillary or venous blood test:
The following is based on NCQA’s HEDIS recommendations:
|The percentage of children 2 years of age who had one or more capillary or venous lead blood tests for lead poisoning by their second birthday||Perform one or more capillary or venous lead blood tests on or before member’s second birthday.|
How does your completion of the TO-DO LIST get recorded?
- Refer to Coding Tables.
Resources available for you and your patients:
- New Blood Lead Level Information, Centers for Disease Control and Prevention: cdc.gov/nceh/lead
- Lead Screening in Children, NCQA HEDIS Measurement Year (MY) Tech Specifications 2022
Lead Screening in Children (LSC) HEDIS Measure Billing Code:
|SNOMED CT US Edition||8655006||35833009|
Supplemental Data Requirements
- Lab report, progress note, or NJIIS form indicating lead test, date, and results.
The most accurate method to submit data for clinical quality gap closure is through correct coding. Supplemental data submission can be used for gap closure when information is not received through coding. All supplemental data must be signed and dated by a treating physician, nurse practitioner or physician assistant. All dates must include month, day and year.
Patient name and birthdate needs to be on all supplemental documentation. If birthdate is not officially on a report, it needs to be either written on the document and signed by the physician, or a demographic cover sheet should be included as an additional page with the submission.
To learn more about your practice’s current HEDIS performance for this or other measures, or for assistance in compliance with the HEDIS guidelines, please contact Horizon Healthy Journey at 1-844-754-2451.
Reference: NCQA HEDIS Measurement Year (MY) 2022 Technical Specs CPT® is a registered trademark of the American Medical Association.
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