Wisconsin Medicaid: Requirements and best practices for lead screening in children

Protecting children from exposure to lead is important for their health and well-being. According to the Centers for Disease Control and Prevention (CDC), even low levels of lead in blood can affect a child’s intelligence, ability to pay attention and academic achievement.

To support your efforts to ensure your pediatric patients are receiving blood lead level tests at the required ages, we’ve gathered state-mandated requirements for lead testing and best practices.

Lead testing requirements

The Wisconsin Department of Health Services (DHS) requires all children enrolled in Medicaid to receive a blood lead level test at:

• Age 12 months
• Age 24 months
• Between ages 3 and 5 for children who have never been tested before

All blood lead tests must be reported to the state. For more information, see DHS guidelines for lead testing and reporting.

Best practices for lead testing

As of Jan. 1, 2024, the Wisconsin Blood Lead Testing Recommendations, P-03557 (PDF), encourage health care providers to practice universal blood lead testing for Wisconsin children. Wisconsin recommends testing all children at age 1, all children again at age 2, and any children between ages 3 and 5 without a previous test.

These recommendations match the federal Medicaid requirement. Additional testing may be recommended in the city of Milwaukee or for any child under age 17 with risk factors for lead poisoning.

We also recommend these additional best practices for lead testing:

• Use your electronic medical record (EMR) lead risk assessment tool
• Test during office visits
• Consider using the LeadCare® II point-of-care test, developed by the CDC, for in-office screening
• Use the correct CPT® codes when submitting claims:
  • Blood lead screening: 83655
  • Collection of capillary blood specimen: 36416
  • If sending the test to a lab by mail or transport, use CPT codes 83655 (lead), 36416 (collection) and 99000 (lab handling fee)

Learn more

You can find more information about requirements and best practices through the Wisconsin Childhood Lead Poisoning Prevention Program.

Questions?

• UnitedHealthcare Community Plan: Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal. You can also call Provider Services at 877-842-3210.
• Wisconsin Department of Health Services Childhood Lead Poisoning Prevention Program: 
  • Call 608-266-5817
  • Email dhsleadpoisoningprevention@dhs.wisconsin.gov

CPT® is a registered trademark of the American Medical Association

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