Friday, January 19, 2018

Coverage BLOOD LEAD NURSING ASSESSMENT VISITS


MDHHS covers up to two blood lead nursing assessment visits and in-home education visits for children determined to be lead burdened. If more than one child in the home has blood lead poisoning, the blood lead nursing assessment visits are covered for each child.

Blood lead nursing assessment visits must be provided in the child’s home. A Medicaidenrolled home health agency or an LHD may conduct the visits. This procedure is not covered under the Maternal Infant Health Program (MIHP). Blood lead nursing visits provided through a MHP are covered by the individual MHP.

The first blood lead nursing assessment visit focuses on:

* Assessment of the growth and developmental status of the child, including any symptomatology that may be present in the child.


* Behavioral assessment of the child, including any aggressiveness and/or hyperactivity.

* Nutritional assessment of the child.

* Assessment of typical family practices that may produce lead risk (e.g., hobbies, occupation, cultural practices).

* Limited physical identification of lead hazards within the dwelling.

* Identification and planning for testing of any other family member at risk for sequelae of lead hazard exposure.

* Education and information regarding lead hazards and ways to minimize those risks in the future.

* Development of a family plan of care to increase the safety of the child from lead hazards.

* Facilitating blood lead follow-up testing and treatment recommended by the PCP.

The second blood lead nursing assessment visit focuses on:

* Reinforcement of the educational information presented to the family during the first visit.

* Validation of the family’s ability to carry out activities to minimize risks of continued lead exposure.

* Modifications of the plan of care to minimize lead risks, as needed.

* Facilitating blood lead follow-up testing and treatment recommended by the PCP.


BLOOD LEAD RESOURCE DOCUMENTS

Providers are encouraged to obtain and review materials and resources concerning blood lead poisoning from the MDHHS Childhood Lead Poisoning Prevention Program. (Refer to the Directory Appendix for contact information.)

FEE-FOR-SERVICE (FFS)

 For beneficiaries younger than 2 years of age, a letter stressing the importance of well child visits is sent to the parent/guardian every six months as a reminder to schedule a well child visit with the PCP. The parent/guardian of the beneficiary is encouraged to schedule the well child visits recommended during those six months with the beneficiary’s PCP. For beneficiaries 2 years of age and older, if a claim for a well child visit has not been processed by Medicaid by the time the child is halfway to their next well child visit due date (according to the AAP periodicity schedule), the parent/guardian will receive a second letter. A list of FFS beneficiaries who did not have a claim for a well child visit processed will be generated and issued to each LHD. LHDs may assist Medicaid in informing parents/guardians of the EPSDT program, scheduling appointments, and arranging medical transportation options.

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