section in this module describes the specific laboratory
tests that are part of comprehensive pediatric
preventive health care. The timing (periodicity) for each
test is based on recommendations for children who are growing
and developing in a healthy way, with no manifestation
any important health problems.
lab test included in this module, the DC Medicaid JealthCheck
Periodicity Schedule indicates the recommended age(s) for
that specific test. More frequent testing may be needed in
certain circumstances (medical conditions, risk factors,
concerns, gaps in continuity or documentation of care).
Documenting Laboratory Tests
- Metabolic and Hemoglobinopathy:
- For 0-4 months: record newborn metabolic tests [pending/normal/abnormal; list comment if abnormal].
- Tests should include sickle cell, G-6-PD deficiency, congenital hypothyroidism, galactosemia, phenylketonuria, maple syrup urine disease, and homocystinuria.
All children covered under Medicaid should receive 2 blood lead tests.
- District law requires all Medicaid-enrolled children receive a lead test at least twice: first between ages 9 and 14 months, and a second time between ages 22 and 26 months.
- In addition, if there is no documentation of previous lead screening, federal law requires that all Medicaid-eligible children between the ages of 36 and 72 months of age also receive a screening blood lead test.
- All other children 36-72
months require a test unless assessed as low lead risk.
Lead level of concern: greater than or equal to 10
NOTE: These requirements compy with federal law requiring that all children covered under Medicaid receive a screening blood lead test at 12 months and 24 months of age. Children between the ages of 36 months and 72 months of age must receive a screening blood lead test if they have not been previously screened for lead poisoning (CMS State Medicaid Manual, Section 5123.2(D)(1)).
more information, contact the DC Lead Poisoning Prevention
Division at (202) 535-2634
- See screening guidelines, verbal risk assessment, and DC lead resources in the Lead Section of the HealthCheck Extended Training.
- Anemia (Hemocrit or Hemoglobin):
- Infancy: all infants at 9 and 12 months (or earlier if high risk). Screen again at 15, 18, and 24 months if high risk.
- For 3-10 years: screen at each visit.
- 11-21 years: screen once between 11 and 20 years; screen menstruating females annually.
- Document: risk [low/high]; if previously done: [normal/abnormal]; or if ordered.
- From 3-21 years: Review and document risk factors [low/high].
- If at high risk: screen with lipid profile blood test.
- Note: AAP recommends lipid profile at ages 6, 8, 10, and annually if at high risk.
- Infancy and early childhood: perform Mantoux skin test (PPD) at 12 months; once between 3-5 years (all children entering school must have a PPD test).
- Early childhood: test once 3-5 years; if at high risk: test between 15-24 months.
- For 8-21: test annually.
- Document: TB risk: [low/high]; if high: [PPD ordered].
- STIs and Pregnancy:
- Infancy: screen all infants born to infected mothers.
- Adolescents: screen all sexually active teens starting at 11 years for STIs; offer pregnancy testing routinely to all sexually active females. Perform a pelvic examination and Pap smear should be performed on all sexually active females and females between 18-21 years.
- Document: STI risk: [low/high]; if high: [screens ordered].