Provider Alerts

Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2023
Lead Screening in Children (LSC)
Guidelines Update

All California providers who perform Periodic Health Assessments (PHA) on
patients between the ages of six months to six years (72 months) must comply
with current federal and state laws and industry guidelines issued by the
California Department of Public Health’s Childhood Lead Poisoning Prevention
Branch (CLPPB). The CLPPB updated guidelines align with the Centers for
Disease Control and Prevention (CDC) guidelines published in 2021.

Lead Testing must be completed:

• Between the ages of 6 months – 12 months AND
• Between the ages of 13 months – 24 months OR
• Between 24 and 72 months where the patient has no record of a previous blood lead screening performed OR
• If patient is refugee status, follows the CDC Recommended guidelines for Post Arrival Lead Screenings of Refugees.

Anticipatory guidance for the dangers of lead poisoning MUST BE documented at every PHA and documentation must include evidence of:

• Oral or written anticipatory guidance/education about the dangers of
  lead poisoning in children provided to the patient’s caregiver AND
• Documentation of lead screening lab orders and results OR
• Documentation of signed refusal from the patient’s caregiver including the reason for refusal.

Results Follow-up
<3.5 mcg/dL Initial blood lead level (BLL) & routine retest may be capillary (CBLL) or venous (VBLL)

• If screened early (before 12 months), retest in 3-6 months as the lead
  exposure risk increases with increased infant mobility.
• Follow up with VBLL in 6-12 months if indicated
• Provide education about common sources of lead exposure and information on how to further prevent exposure appropriate milestones
  are being met.
  ≥3.5 mcg/dL Initial BLL may be capillary or venous. Every retest must be venous.
• Follow the recommendations for <3.5 mcg.dL results AND
• Report the test results to your state or local health department.
• Obtain an environmental exposure history from the caregiver to identify potential sources of lead.
• Follow the CDC guidelines for retesting:
  Recommended Actions Based on Blood Lead Levels | Lead | CDC

For more information and Resources please visit:

• Childhood Lead Poisoning Prevention Branch (CLPPB) (ca.gov)
• Blood Lead Reference Value | Lead | CDC
• Lead Screening Guidelines: Domestic Guidelines | CDC

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