November 2018

Texas Health Steps Laboratory Screenings and Age-band Requirements

Blue Cross and Blue Shield of Texas (BCBSTX) performs a quarterly medical record review of Texas Health Steps (THSteps) checkups. The periodicity schedule is used to audit medical records and ensure members are receiving timely care per the required checkup components.

One component of the THSteps checkups is laboratory screenings, which are performed from birth through 20 years of age. Some testing is performed in the birthing facility within 24 to 48 hours after birth. Subsequent follow-up testing is performed in a provider’s office and may be required or may be risk-based. Review the Texas Health Steps Risk-based Guidance tool.

Laboratory screenings at proper intervals can identify disease processes and risk so care can be provided within an appropriate time frame.

Screening tests and their age-band requirements include:

• Anemia – mandatory at 12 months and whenever symptoms suggest anemia
• Blood Lead-level – mandatory at 12 and 24 months, and whenever lead exposure has been uncovered
• Dyslipidemia – mandatory at 9 years and 18 years, and risk-based 2 years through 20 years
• Type 2 Diabetes – 10 years or onset of puberty if earlier
• HIV – mandatory at 16 years, and risk-based 11 years through 20 years
• Sexually transmitted disease/infection – risk-based 11 years through 20 years

Provider Action:

• Reach out to your patients and encourage them to schedule their annual THSteps checkups.
• If needed, reference the periodicity schedule to make sure checkup components are timely.
• Obtain laboratory screenings at appropriate intervals per the THSteps periodicity schedule.
• Educate patients on the importance of preventive care.

Thank you for your continued partnership in providing the best care to our members, your patients. If you have any questions about the Quality Improvement Department or BCBSTX initiatives for THSteps, reach out to:

Kathleen Thompson, MPH, CPHQ
Director, Quality TX Medicaid, Government Programs 
Kathleen_m_thompson@bcbstx.com 
512-349-4836

Julie Sones, R.N.
Quality Management Specialist III         
julie_l_sones@bcbstx.com
512-795-5904