Product Lines:
Priority Partners.

Eligible Population:
Members 2 years of age as of December 31 of the measurement year. This includes Value Based Purchasing (VBP) for Priority Partners.

Definition:
Children must have at least one capillary or venous blood tests on or before their second birthday.

Eligibility criteria:

• Enrolled on the child’s second birthday:
  • Continuously enrolled 12 months prior to the child’s second birthday.

Best Practice and Measure Tips

• Assessment alone does not meet criteria for this measure – be sure to order the blood test and be sure it is completed.
• Document in the medical record the date the test was performed and the result or findings. “Unknown” is not considered a result/finding.
• Educate parents on the importance of screening for lead poisoning – while the child may not be exposed at home, other environments may present a new risk.
• Visit the MD Department of Health and the Centers for Disease Control and Prevention (CDC) website for additional information for providers and parents / caregivers:
  • https://health.maryland.gov/phpa/OEhfp/eh/Pages/Lead.aspx
  • https://health.maryland.gov/phpa/OEHFP/EH/Shared%20Documents/Lead/HB1233_ClinicianLetter_03022021.pdf
  • https://www.cdc.gov/nceh/lead/default.htm

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year.
• Members who died any time during the measurement year.

Measure Codes

Lead Test 

• CPT Codes: 83655
• LOINC Codes: 10368-9, 10912-4, 14807-2, 17052-2, 25459-9, 27129-6, 32325-3, 5671-3, 5674-7, 77307-7