Provider Alerts

Healthcare Effectiveness Data and Information Set (HEDIS) Measure for 2022-(LSC) Update

The following is an update to the provider alert you received in July 2022, please note that lead values have been added.

Description: All providers who perform periodic health screenings on members between the ages of six months to six years (i.e., 72 months) must comply with current federal and state laws, and industry guidelines for health care providers issued by the California Department of Public Health’s Childhood Lead Poisoning Prevention Branch (CLPPB).

Testing:

• 12 months of age and 24 months of age
• Between 24 and 72 months with no record of a previous blood lead screening should receive at least one test.

Anticipatory Guidance

Medical record results must be documented and include – not optional:

• Oral or written anticipatory guidance to a parent or guardian of the child.
• Information that children can be harmed by exposure to lead.
• Documentation of signed refusal and the reason for refusing to consent to testing.

Results Follow-up:

< 5 mcg/dL Initial BLL and routine retest may be capillary (CBLL) or venous (VBLL) 3,4 Retest for identified risk must be venous if –

• screened early (before 12 months), retest in 3-6 months as risk increases with increased mobility. Follow up with VBLL in 6-12 months if indicated.

Additional anticipatory guidance is provided on page two.

Results follow up:

5-9 mcg/dL Initial BLL may be capillary or venous Every retest must be venous

• Retest in 1-3 months to be sure BLL is not rising.
• Then retest in 3 months and thereafter based on VBLL trend.

10-14 mcg/dL Initial BLL may be capillary or venous Every retest must be venous

• Retest in 1-3 months to ensure BLL is not rising.
• To determine eligibility for full public health case management, retest after interval of 30 days (eligible if persistent in or above this range)
• If BLLs are stable or decreasing, monitor initially with VBLLs every 3 months and thereafter based on VBLL trend. If retest is in another range, retest per that range

If you have questions or need assistance, please call our Provider Services team at (209) 942-6340. You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.