During National Lead Poisoning Prevention Week, it’s a good time to raise awareness about the dangers of childhood lead exposure. Lead is one of the most common yet preventable environmental health threats. Even at low levels, lead can harm brain development, the nervous system, and overall health. California’s 2025 theme, “Nutrition as Prevention,” highlights how diets rich in calcium, iron, and vitamin C can reduce lead absorption.[1]
Clinical Guidelines
Both federal and state laws mandate blood lead testing (finger prick or venous blood draw) for children in government assistance programs, such as Medi-Cal/CenCal Health, at ages 12 and 24 months[2] with catch-up testing if missed.
Care Components of Lead Exposure Management:
- Risk Assessments – Complete at every well-child visit from 6 months to 6 years.
- Testing – Test at ages 12 and 24 months; order catch-up testing if missed.
- Anticipatory Guidance – Educate families on risks and prevention; provide appropriate resources.
Quality Care Incentive Program (QCIP)
Pediatric Primary Care Practitioners are eligible for incentives for members who receive one or more capillary or venous lead blood tests by their second birthday. A gap in care opportunity report is available on the Provider Portal within the QCIP section, for members who may be behind the recommended testing schedule.
- Use CPT code 83655 when billing for lead testing.
Practice Transformation
- Implement alerts for testing and identify children who have never been tested.
- Screen for lead exposure at every well-child visit from 6 months to 6 years of age.
- Offer point-of-care lead testing in your office. If not available at your practice, document the lead test order.
- Distribute anticipatory guidance/health education material about lead exposure testing.
- Record instances where a risk assessment or lead test is not administered or refused. Download the refusal form template.
- Report abnormal lead tests to your county’s Department of Public Health and the California Lead Poisoning Prevention Branch.
- Download Health Education materials to share with parents/guardians: Patient Education Materials.
For additional questions, contact the Population Health team at populationhealth@cencalhealth.org.
Resources
- American Academy of Pediatrics Patient Care Lead Exposure
- CenCal Health Lead Testing Protocols & Tips
- California Management Guidelines on Childhood Lead Poisoning for Health Care Providers
- Ways to Reduce Anxiety in Children Getting Blood Lead Tests
- DHCS: Blood Lead Testing and Anticipatory Guidance
[1] https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/CLPPB/Pages/LeadWeek2025.aspx
[2] https://www.cdc.gov/lead-prevention/hcp/clinical-guidance/index.html?utm_source