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Screenings for Medi-Cal members

Provider news | Monday, June 1, 2020

Each wellness visit consists of numerous screenings. Among the covered services that Medi-Cal providers should render to members, screenings include:

Childhood developmental screenings
This screening should be administered during each well-child visit within a child’s first three years. The screening is intended to track language, movement, thinking, behavior, and emotional development. Screening must include scoring and documentation using a standardized screening tool that meets criteria set forth by the American Academy of Pediatrics (AAP) and the Centers for Medicare and Medicaid Services (CMS). To bill upon completion of screening, use CPT code 96110 (developmental testing, with interpretation and report).

For more information, see the childhood developmental screening billing resource on our website.

Blood lead level screenings
Protecting children from exposure to lead is important to lifelong good health. Lead in blood has been shown to negatively affect IQ, ability to pay attention, and academic achievement. Medi-Cal covered children are required to be given a blood test to measure the level of lead in their blood at 12 and 24 months or at any time up to age 72 months if the provider cannot determine if a blood lead test has been done previously.

More information about California’s Childhood Lead Poisoning Prevention Program, including resources and parent educational materials, can be found on the California Department of Public Health’s website. Specific information about blood lead and anticipatory guidance can be found on the Department of Health Care Services’ (DHCS) website.

To bill for screening, use CPT Code 36416 Capillary Collection.

Trauma screenings
Trauma-informed care is a model of care intended to promote healing and reduce the risk of re-traumatization. Early identification of trauma and providing the appropriate treatment are critical tools for reducing long-term health care costs for both children and adults. The State of California is providing training and clinical protocols to screen children and adults for adverse childhood events (ACEs) and respond with trauma-informed care to improve patient health and well-being. This free, two-hour online training will certify providers to receive Medi-Cal payment for ACE screenings.
• Visit ACEs Aware’s website for provider training.
• Visit DHCS’s website to complete the training attestation.

To bill for screening, use billing codes G9919 (positive screen with patient score of 4 or greater) and G9920 (negative screen with patient score of 0 to 3).

Read more news in the June issue of Provider e-News