Wisconsin Medicaid requires pediatric blood lead screening

As a reminder, lead screenings are a Medicaid requirement in Wisconsin for pediatric patients. As of Jan. 1, 2024, Wisconsin updated their guidelines to recommend that health care professionals practice universal blood lead testing.  

Wisconsin recommends* testing:

• Children at age 1
• Children again at age 2
• Any children between ages 3 to 5 without a previous test

You also must report all blood lead tests to the state of Wisconsin.

Lead testing requirements

We want to support your efforts to help ensure your pediatric patients who are UnitedHealthcare Community Plan members are receiving blood lead level tests at the required ages. We’ve outlined the following state-mandated lead testing requirements and tips for you and your practice.

Additional tips for lead testing

• Use your electronic medical record lead risk assessment tool. If you answer “yes” to any of the questions, we require a capillary finger stick test of venous blood test
• Consider using the LeadCare® II point-of-care test, developed by the CDC, for in-office screening
• Use the following 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)

Questions?

• Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
• Wisconsin Department of Health Services Childhood Lead Poisoning Prevention Program:
  • Call 608-266-5817
  • Email dhsleadpoisoningprevention@dhs.wisconsin.gov