Newborn Screening - Frequently Asked Questions

The Texas Newborn Screening Program is an essential public health program that includes:

• Laboratory bloodspot testing for more than 50 disorders
• Point-of-care screenings for 2 more conditions
• Follow-up, case management, and outreach for infants with out-of-range test results

Newborn Screening is required by law for any baby born in Texas (Health and Safety Code, Chapter 33) and identifies babies that may have a specific disorder or medical condition. Early treatment of these disorders can help prevent serious complications or even death.

Texas does not test for all of the disorders listed on the Recommended Uniform Screening Panel (RUSP). The current Texas Newborn Screening panel does not include:

• Glycogen Storage Disease Type II (Pompe)
• Mucopolysaccharidosis Type 1 (MPS I)
• Galactoepimerase deficiency (GALE)
• Galactokinase deficiency (GALK)

View a list of the conditions on the Texas Newborn Screening Panel.

Most children born with these problems appear healthy at birth and are from healthy families. Parents who already have healthy children, or who are "silent carriers" of a genetic condition, do not expect any problems. Because every baby is tested soon after birth, children who may have one or more of these disorders can be identified early and get early care. This can make a tremendous difference in health outcomes for the child

Texas law (Health and Safety Code, Chapter 33) requires that all newborns are screened for certain genetic disorders or medical conditions recommended by the Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC) on the Recommended Uniform Screening Panel (RUSP). Currently for Texas, this includes screening for 31 core conditions, 24 secondary conditions* and point-of-care screens. A list of the conditions on the Texas Newborn Screening Panel can be found here (pdf).

*Note Although the primary mission of NBS is to identify newborns at highest risk for the core conditions, secondary conditions may also be detected during screening for core conditions.  Additional testing may be needed to determine whether it is the core condition or a secondary condition. 

The newborn screen may NOT identify all babies with the disorders on the panel.  The newborn screening test identifies babies at risk of having a disorder on the panel. The number of babies with secondary conditions that are not identified by screening may be higher than for core conditions. If there are clinical symptoms or family history of a condition, the newborn screen results alone should not be used to rule out or confirm a condition; diagnostic testing should be pursued. The newborn screening results should be considered by a medical professional in conjunction with family history and diagnostic testing, when warranted. 

The term “PKU test” is outdated as well as misleading since phenylketonuria (PKU) is one of over 50 disorders on the Newborn Screening Panel. Telling a parent their newborn has an abnormal “PKU test” can be confusing. The abnormal screening result may be for a different disorder on the Newborn Screening Panel.  In addition, when calling the DSHS Laboratory to request a Newborn Screen report, it is imperative for it be referred to as the Newborn Screen in order to receive the correct results.

A false positive test result occurs when a test indicates that a person has a particular disorder when they actually are not affected by the condition.

A false negative test result occurs when a test indicates that a person does not have the particular condition when in fact they do have it. 

Each state develops their own screening test cutoffs, which are appropriate for their state’s population. Screening test cutoffs are calculated to allow for identification of babies with the disorder while minimizing both false positive and false negative results. In Texas, screening test cutoffs are determined by performing a study to identify the level of the analyte(s) that is indicative of the disorder. The study takes into account published data, the test method, and the type of equipment that will be used. Cutoffs for certain disorders also require considering infant specific factors such as age of the baby at specimen collection, birthweight, prematurity and transfusion status.  A sufficient number of specimens representing the Texas newborn population and true positive specimens, if available, are tested to determine the range where we would expect results from babies without the disorder to fall.  If a baby has results outside this range, then those results would be considered abnormal and would require additional testing.  Test cutoffs are routinely re-evaluated by comparison to diagnosed case test values and false negative specimen results. In addition, the cutoff may also be revised to reduce the number of false positive results.

DSHS screens for many but not all diseases your baby may have. More tests can be done. For more information, ask your baby’s doctor and visit www.babysfirsttest.org/find-condition or savebabies.org/resources/pregnant-families.

Note: DSHS has no affiliation with these sites and the opinions and positions of these organizations may not reflect the opinions and/or positions of DSHS.

DSHS has implemented a two-screen system to maximize the effectiveness of testing for all disorders on the Texas Newborn Screening Panel.

Two screens are completed in Texas to detect some of the disorders at the earliest possible opportunity. The first screen should be collected between 24 to 48 hours of age and the second screen between 7-14 days of age.

In Texas, the second screen routinely detects babies at risk for severe medical complications. These babies sometimes have a normal first screen. 

After a baby is born, their physiology changes rapidly and sometimes it takes a week or more for these changes to occur. In some cases, a disorder may only be detected on the second screen due to these physiological changes.  

In addition, some disorders (like cystic fibrosis) rely upon both newborn screens to reduce the number of babies who would otherwise require additional testing with a specialist to determine whether they have the condition or not. 

The goal of the Texas Newborn Screening Program is to identify babies who have these devastating diseases before symptoms arise so that they can receive appropriate treatment and lead productive and healthy lives.  Having a second screen improves medical providers’ ability to identify children with disorders who would have otherwise gone undetected.

The healthcare provider collects the blood sample. The DSHS public health laboratory in Austin performs the laboratory testing.

An abnormal or “out of range” test result indicates that the baby may be at higher risk of having one or more of the disorders included on the newborn screening panel. This does not mean that the baby definitely has a disorder. In fact, most babies who receive "out of range" results do not have the condition of concern. If the newborn screen indicates “out of range” results, parents are contacted by their child’s healthcare provider. It is important that parents follow their healthcare provider’s directions for their child’s immediate care and additional testing.

Most of these conditions can be treated but not cured. In these cases, early and continuous treatment can result in dramatic positive outcomes for the child and help prevent or control the serious effects of these disorders. Severe Combined Immunodeficiency (SCID), which was added to the newborn screening panel in 2012, is the one disorder on the panel that if identified early in life can be treated and for which most patients can be cured.

Healthcare providers or facilities purchase the specimen collection kits *(which includes the cost of the testing) for private pay or insurance covered patients. DSHS provides specimen collection kits at no cost for patients covered by Medicaid, CHIP, and Title V. DSHS is reimbursed by Medicaid, CHIP, and Title V for the testing performed on these kits.

Parents can only refuse to have their child screened if the screening conflicts with a parent’s religious tenets or practices (see Texas Health & Safety Code Sec. 33.012). In order to refuse, a parent must sign a form stating he/she has a religious objection to newborn screening. Points to consider before refusing newborn screening:

There are important medical benefits of newborn screening.

Symptoms of a newborn screening disorder can appear much later, after a child’s health has already been injured by the disease.

The screen is mandated by law.

The only legal reason to refuse newborn screening is if it conflicts with your religious tenets or practices.

If parents have concerns, they should talk to their baby’s physician or contact the NBS Program Staff by phone at (888) 963-7111, ext. 7333 or email newbornscreeninglab@dshs.texas.gov

Newborn screening of the blood spot consists of a series of tests to look for 53 diseases that can cause a baby to get really sick or die if they are not identified and treated early. The diseases can cause growth problems, mental or physical delays, deafness, blindness, seizures, and early death. Most babies with these conditions look perfectly normal when they are born, and problems may not appear for several weeks or months. About 1 child out of every 500 screened has one of these newborn screening conditions.

Because an interpretation of the result report may be necessary, it is recommended that newborn screening results be released to physicians or medical professionals only. 

Individuals (if over 18) or parents (if under 18) may:

1. Talk to your healthcare provider. Healthcare providers can request newborn screening results for their patients by contacting DSHS Laboratory Reporting, Monday through Friday 8am to 5 pm, by either: Sending a fax request to 512-776-7533 or calling 512-776-7578. OR
2. Visit DSHS Lab Patient Results for information on how to obtain copies of your/your child’s test results.  

Because an interpretation of the result report may be necessary, it is recommended that newborn screening results be released to physicians or medical professionals only.

Individuals (if over 18) or parents (if under 18) may:

1. Talk to your healthcare provider. Healthcare providers can request newborn screening results for their patients by contacting DSHS Laboratory Reporting, Monday through Friday 8am to 5 pm, by either: Sending a fax request to 512-776-7533 or calling 512-776-7578.
2. Fill out the authorization form linked below to request the newborn screening results be sent to a specific physician. If requesting that the results be sent for university records, the school’s physician or nurse information should be included. Fax the completed form to DSHS Laboratory reporting at 512-776-7533.

Authorization to Disclose Protected Health Information (or other confidential information) Form (PDF 34kb)

The Texas DSHS Laboratory Reporting Department can provide newborn screening results from 1991 to present.

The Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards is the form used by parents or guardians to give consent to store Newborn Screening residual blood spots. This form allows the parents or guardians to decide what they want to happen with their child’s residual blood spots.  No matter the parent’s choice, information that can identify them or their child will NOT be released outside DSHS without additional written consent.  

The Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards is page 2 of the Newborn Screening Collection Kit. As of June 1, 2012* TAC 25.1.37D, Rule 37.55 states that the Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards must be distributed to the parents or guardians by healthcare workers, upon the collection of each newborn screening specimen.  The provider shall ensure the completed and signed form is promptly sent to DSHS as per TAC 25.1.37D, Rule 37.56.The form may be returned with a specimen shipment or mailed to the DSHS address listed on the form.

*View specimens collected prior to June 1, 2012.

The Texas Department of State Health Services (DSHS) Newborn Screening Laboratory recommends that five blood spots be collected for the newborn screen. This ensures that there will be enough blood to complete all initial newborn screening and any additional testing. The blood that remains after all testing is complete is the residual blood spots. 

By Texas Law (Health & Safety Code Sec. 33.018 (b)-(c)), the residual blood spots are retained for up to two years and may be used during that time.  DSHS Laboratory keeps residual blood spots in a secure place.  The residual blood spots will be destroyed within two years unless otherwise permitted by the parent or guardian. 

Uses within the two years include:

• Ensuring DSHS Laboratory newborn screening tests, equipment and supplies are working
• Developing new tests for newborn screening
• Studying diseases that affect public health as allowed by law

If the parent or guardian selects OK, the residual blood spots will be stored safely up to 25 years and may be used for public health research outside of DSHS. This research may include the study of public health problems such as cancer, birth defects or other diseases. No matter the parent’s choice, information that can identify them or their child will NOT be released outside DSHS without additional written consent. View the data use policy and a list of research uses that have been allowed by DSHS.

No. The parent or guardian can take home the Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards, page 2 of the Newborn Screening Collection Kit. They can then complete, sign and mail the form at any time. It should be mailed to the DSHS address listed on the form, or they can return it to the hospital, doctor’s office, or collection facility. 

Yes, if the parent or guardian has changed their mind about the use and storage of the blood spots or if they do not remember completing one previously, then they should complete a new Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards, which is page 2 of the Newborn Screening Collection Kit. The provider shall ensure the completed and signed form is promptly sent to DSHS as per TAC 25.1.37D, Rule 37.56. The form may be returned with a specimen shipment or mailed to the DSHS address listed on the form. DSHS will act upon the latest valid and applicable Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards received.

The parent or guardian stated that they already completed the Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Card.  Are we, the healthcare workers, required to distribute a new Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Card, page 2 of the Newborn Screening Collection Kit for the second newborn screen? 

Yes. TAC 25.1.37D, Rule 37.55 states that the Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards, page 2 of the Newborn Screening Collection Kit, must be distributed to the parents or guardians by healthcare workers, upon the collection of EACH newborn screening specimen.  The provider shall ensure the completed and signed form is promptly sent to DSHS as per TAC 25.1.37D, Rule 37.56. The form may be returned with a specimen shipment or mailed to the DSHS address listed on the form.

Yes. Additional copies of the Parent Decision Form for Storage and Use of Newborn Screening Blood Soot Cards are available. The parent or guardian can mail the completed form to the DSHS address listed on the form. DSHS will act upon the latest valid and applicable Parent Decision Form for Storage and Use of Newborn Screening Blood Spot Cards received.

Yes. Healthcare providers should check the box on the Newborn Screening Specimen Collection Kit Demographic form, page 3, in the lower right-hand corner, indicating that the parent information and decision form were distributed. 

Download an Order Form for Newborn Screening Supplies.
Or contact the Container Preparation Group at 1-888-963-7111 ext. 7661 (512-776-7661) or at mailto:ContainerPrepGroup@dshs.state.tx.ustexas.gov to obtain a copy of the order form.

Complete the order form by specifying the total number of kits needed by your facility. There are two kinds of Newborn Screening Kits: 

1.    NBS 3 – Medicaid/Charity Care/CHIP

2.    NBS 4 – Insurance/Self-Pay

Return envelopes and submitter labels are also provided at no charge. Indicate the quantity needed on the order form. Order a quantity of kits to last 1-3 months.

Fax the completed form to 512-776-7672. Orders will be processed and shipped within 5 working days from the day your order is received by the Container Preparation Group. (Note: Normal shipping [in transit] time is 1-3 days business days.)

Additional Information: 
NBS 3 (Newborn screening kits for Medicaid-eligible, Charity Care, or CHIP) kits are provided at no charge. For NBS 4 (Insurance or Self Pay) kits, an invoice will be sent later. Payment will be due within 90 days.

To update your facility’s contact information, complete the Submitter Identification Number Request/Update Form. 

This form is used for new submitters, as well as established submitters who need to update their information. When completing the form for an update, please make sure the “Updating Submitter Information” box is checked at the top. 

Fax the completed form to Laboratory Reporting at (512) 776-7533. 

SHARING CARDS IS STRONGLY DISCOURAGED. Every effort should be made to monitor inventory and plan accordingly for ordering. ONLY share or borrow cards if absolutely necessary.

Please be aware of the potential complications with sharing/borrowing cards:

1.    The result reports for the newborn screens will go to the original facility that purchased the kits UNLESS:

2.    The borrowing facility information (including submitter ID #) is placed in the submitter information portion of the demographic form of the newborn screening kit.

3.    DSHS is not responsible for billing issues that arise when borrowing/sharing cards. Any reimbursement arrangements for shared/borrowed cards need to be made between the facilities involved.

Please see above for information on ordering Newborn Screening supplies.

The Texas Newborn Screening Program requests the collection of blood spots on two separate occasions for each child. The first screen is collected after 24 hours but before 48 hours of age, or prior to the newborn's discharge from the hospital. The second screen is collected at 7-14 days of age.

Reference (normal) ranges are set for a specific population. The DSHS reference ranges are set for specimens collected at 24-48 hours of age and a different set for specimens collected at 7-14 days of age. In the laboratory specimens are categorized by the age of the baby when the specimen was collected.

Collection of the first screen at 23 hours may not have a large impact. To accurately detect amino acid disorders, the infant really needs time to metabolize their first protein feedings. There may not be much difference in laboratory results between 23 and 24 hours. However, if a specimen were collected at 6 or 12 or 18 hours that will probably have some impact on the metabolites that are measured and their potential to be elevated.

Collection of a second screen at 6 days could have a large impact because it can lead to false negative results for fatty acid oxidation disorders. Fatty acid markers quickly start to normalize after the first few days of life. Fatty acid oxidation abnormal ranges are higher for first screen specimens than for second screen specimens. A specimen collected at 6 days will be analyzed using first screen reference values.

The Texas NBS Laboratory does not reject specimens collected on older children. The recommended collection time periods and the NBS testing methodologies have been designed to minimize the number of false negative and false positive results in newborns and young infants. When the newborn screen specimen is collected before 24 hours of age or on older children, the test may not identify some of these conditions. If there is a clinical concern, diagnostic testing should be initiated.

See table below to determine necessity of a third screen:

Newborn Screening Clinical Care Coordination

The healthcare facility should document all attempts made to the parent/guardian and keep the documentation in the baby’s medical record.

If the baby’s 1^st screen was normal, obtain the 2^nd screen when the casts are changed or removed.

If the baby’s 1st screen was abnormal, follow Newborn Screening Clinical Care Coordination guidelines.

If the baby’s 1st screen was unsatisfactory, refer to Alternative Methods for Collecting a Newborn Screen.

The heel-stick is the preferred method for optimal laboratory results for the newborn screen. However, it is understood that certain circumstances may warrant alternative collection methods. For more information, please see the Specimen Collection – Special Circumstances web page, or the Alternative Methods for Collecting a Newborn Screen page.

Visit the DSHS Specimen Collection Requirements page or the Healthcare Provider Resources page.

Quick tip: Save these webpages as favorites for easy access whenever needed.

A parent can refuse the screen for religious reasons only (Texas Health & Safety Code Sec. 33.012).  Make sure you and your staff are familiar with the benefits of screening and the consequences of undetected disorders. 
Points to consider before refusing newborn screening:

• There are important medical benefits of newborn screening.

• Symptoms of a newborn screening disorder can appear much later, after a child’s health has already been injured by the disease.

• The screen is mandated by law.

• The only legal reason to refuse newborn screening is if it conflicts with your religious tenets or practices.

Provide this information to parents who are considering refusing the screen. Download the Religious Objection to Newborn Screening Test form below and provide to parents who are sure they want to refuse newborn screening for their infant. The refusal of newborn screening must be signed by the parent/legal guardian/managing conservator and entered in the infant’s medical record.

English Form:  

FORM TO REFUSE THE NEWBORN SCREENING BLOOD TEST

Spanish Form: 

FORMULARIO DE RECHAZO DE LA PRUEBA DE DETECCIÓN TEMPRANA EN SANGRE A RECIÉN NACIDOS (NBS)

INSTRUCTIONS TO COMPLETE FORM TO REFUSE THE NEWBORN SCREENING BLOOD TEST 

No. One kit is required for each screen. Each child will require two screening test kits.

It is understood that it may not be possible to send all specimens as soon as possible after collection, especially for those specimens drawn before weekends or mail holidays. Specimens should be dried thoroughly and sent to DSHS as soon as possible, preferably by overnight courier.

Rules emphasize the importance of the timely collection and mailing of specimens so that children with these disorders can be identified, diagnosed and treated quickly. However, the first priority is to provide an acceptable specimen. Do not ask the parent/child to return later as this will delay the screening. Do not ship specimens wet.

New national recommendations state that first screen specimens should arrive at the DSHS Laboratory within 24 hours after collection. Ideally, specimens should arrive the day after collection. 

• DO NOT delay shipment of newborn screening specimens. Ship dried specimens as soon as possible, preferably via overnight courier. If mail or courier services are unavailable, ship as quickly as possible.

• DO NOT batch or hold dried specimens for shipping.

• Ship dried specimens directly from the collection facility to the DSHS Newborn Screening Laboratory.

Identify internal processes which may delay shipment and look for possible improvements. 

See Decreasing Time Between Collection of Newborn Screening Specimens to Receipt in DSHS Laboratory (PDF 861kb)

The information in the “mother information” section of the Newborn Screening kit should reflect who the child will be in the care of upon release from the healthcare facility. This information is required for multiple laboratory and follow-up purposes. Most importantly, it is necessary for the Newborn Screening Clinical Care Coordinators to have accurate contact information of the child’s caregiver in the event that there is an abnormal newborn screen.

The “charity care” newborn is a patient who is not insured, has a parent or guardian who is unable to provide payment, AND is not covered or eligible to be covered for newborn screening services by Medicaid, CHIP, or any other government program.

Please submit the specimen on the kit collected. DO NOT ALTER THE KIT IN ANY WAY. DSHS performs data analyses to identify Medicaid eligible specimens collected on Paid / Insurance cards. If a Medicaid eligible patient has a specimen collected on a Paid / Insurance card, the facility’s account will be credited for the cost of the kit.  The data analysis and reimbursement process takes 6 - 9 months.

Please submit the specimen. Note on the collection kit that the specimen should have been collected on an Insurance / Self-Pay card. DSHS will bill the facility for the cost of the kit.

Use the Insurance/Self-Pay card. If the child is later identified as Medicaid, the provider will be reimbursed in 6-9 months for the cost of the card.

In this scenario, the provider should use the Medicaid card.

Yes. STAR plans are Medicaid- managed care plans. Patients seen under these plans are eligible for Medicaid. You will not be charged for kits for Medicaid-eligible, CHIP, and charity care newborns.

DSHS will begin to accept exchanges on the date following kit expiration.  (For kits that expired on September 19, 2017; exchange requests will be accepted starting on September 20, 2017. Kits that have expired prior to the most recently expiring kits will not be accepted for exchange. 

No, NBS3 kits do not need to be returned to DSHS for exchange. Expired NBS3 kits can be discarded. 

Expired and unused NBS specimen collection kits can be discarded in the regular garbage, recycled with paper recycle, or shredded.

Complete the G-6D “Newborn Screening Supplies” order form. Count the number of expired NBS4 kits. Write the number of forms to be exchanged in the “Quantity Requested” box and write “Exchange” in the “Billing – Purchase Order Number” box section of the form. 

The completed G-6D form and expired kits should be mailed to: 

For Overnight/Priority Shipping (UPS, DHL, FedEx, etc): 

Texas Department of State Health Services

Container Preparation Group

Laboratory Services Section, MC 1947

1100 W. 49th Street

Austin, TX 78756-3199 

For regular mail: 

Texas Department of State Health Services

Container Preparation Group

Laboratory Services Section, MC 1947

PO Box 149341

Austin, TX 78714-9341 

The cost for shipping is the responsibility of the submitter. 

Allow DSHS 5 business days from receipt of exchange request to process the request.

Although the same form is used to both request an exchange of expired forms and to order new kits, a separate form must be filled out for each type of request. If additional new kits are ordered on the same G-6D form as the request for exchange of expired kits, only the exchange request will be processed.

Example: 20 expired kits are sent in for exchange and 100 additional kits are requested on the same G-6D form. DSHS will only send out 20 new kits to cover the number returned for exchange. 

No, DSHS will only accept requests to exchange kits that have already expired. 

You have up to 3 months after the expiration date to submit a request to have expired NBS4 kits exchanged for non-expired kits.

No. When an exchange request is received, DSHS will automatically send new kits for the exact number of kits that were returned. 

No. Expired NBS4 kits cannot be returned for a refund or credit. DSHS will automatically process the request as an exchange. 

1. Fill out:

• Facility Security Agreement (PDF 40kb) (1 per facility) AND

• Web User Access Agreement (PDF 41kb) (1 for each user)

2. Submit the completed forms:

• Fax to: 512-776-7223, Attn: Remote Lab Support, L-601

• Or e-mail to: mailto:remotelabsupport@dshs.state.tx.us

For help, call: 888-963-7111, ext. 2484 or ext. 6275.

A Newborn Screening Submitter ID is required to complete this paperwork. If the facility does not have a Submitter ID, see the next question and answer below.

Metabolic specialists, endocrinologists, pediatricians and other healthcare providers often need quick access to newborn screening results for their patients. It is not requirement that a facility submit newborn screening specimens in order to access newborn screening results online. However, healthcare providers/facilities are required to have a Submitter ID to access newborn screening results online.

Healthcare Providers/Facilities can obtain a Submitter ID or use the Submitter ID for a facility with which they are associated.

If you are a healthcare provider that would like to obtain a Submitter ID:

Complete the Submitter Identification Number Request/Update Form. 

If your facility will not be submitting newborn screening specimens, in the box “Type of tests to be submitted,” fill in with “None. Need online access to NBS results.”

Fax to Laboratory Reporting at (512) 776-7533.

Once you have obtained a Submitter ID, signup for online access by following the steps outlined in the question & answer above, How do healthcare providers get access to the Texas Newborn Screening Web Application.

If you are a healthcare provider that would like to use a Submitter ID for a facility with which you are associated, call the telephone number below for help.

For help, call: 888-963-7111, ext. 2645 or ext. 6030. 

The Newborn Screening Report Card provides a monthly report on your facility’s NBS submissions; including number of specimens submitted and specific information on specimen quality and demographic issues.

Refer to the Guide to the Newborn Screening Report Card (PDF 111kb) for more information on each category.

Access to the report allows the facility to:

• Identify strengths and opportunities for improvement.

• Compare your facility’s performance with others in the state.

To access your facility’s report card, you must be a registered user of the Texas Newborn Screening Web Application (Neometrics). If you are not already a registered user, you can sign up to become a registered user of the Texas Newborn Screening Web Application.

Send an email request for a password reset to remotelabsupport@dshs.texas.gov. Business hours for assistance are 8am-5pm Monday through Friday.

Results will be available in the web application 4 to 7 working days (Monday - Saturday) after receipt of the specimen, in most cases.

Results will be available indefinitely. Currently, users can access results for any specimens reported after mid-February of 2007. To access result reports for earlier specimens, providers must contact the DSHS Laboratory Reporting Group (fax 512-776-7533 or call 512-776-7578).

Call DSHS Laboratory Reporting at 512-776-7578 to request to opt out of hard copy reports.

To view result reports, the web application requires Adobe Reader 8.0 or higher. If you have an older version, this error will occur. Update your version of Adobe Reader.

Yes. In the Access Result Reports module, uncheck Submitted Samples Only before performing a search. For additional security purposes, the user must use a combination of multiple search fields to access the result report. Recommended search criteria for SRV criteria. (PDF).

The web application includes features that maximize patient privacy and ensure compliance with HIPAA Security rules.

If you are having trouble accessing results for a patient, check out the general SRV search tips (PDF) or send an email request for assistance with the website to: mailto:NBSRemoteDataServices@dshs.state.tx.us.

A few quick reminders:

• Search with as few fields filled in as possible.

• If there are any differences between what is searched for and what is in the system, results will not be retrieved.

• The search combinations outlined in the Search Tips document (linked above) are the ONLY combinations allowed when searching for results for specimens that were not submitted by your facility.

• When searching for results for specimens submitted by another facility, you must un-check the “Submitted Samples Only” box.

The following is a list of just some of the label printers that have been tested with this system. Other similar printers will likely be configurable as well.

• Zebra LP2824

• Zebra TLP 3742

• DYMO Label Writer 400 Turbo

• Brother P-touch QL-5000

• SII Smart Label Printer

For complete instructions for configuring your printer and web browser, download  Lab NBS Provider Web Installation (PDF 834KB)

No. If you place a web label on the NBS card, you do not have to complete the form.

Through the web system, you may re-access the submitted specimen using the Search option under the Enter NBS Demographics module. Choose to edit the demographics for the specimen in question. Make any necessary changes to the demographic information and submit the specimen again. You will then be prompted to print a label.

If your printer is configured to initiate a print dialog at each print, there will be an option to choose the number of copies within that dialog. If you will always print multiple labels, the number of copies can be set in the printer preferences.

Although the system is configured to print to a label printer, if you prefer to print to labels on a laser printer see PDF directions located at: NBS Procedure Print Label Web Application (PDF) 

There is not a default setting to automatically print labels to the label printer and other documents to the networked printer. If you have the default set to the label printer but want to print documents to another printer, you will have to either change the default printer to the laser one you wish to print to, or select the laser printer from the print dialog box.

Since this is a secure site, the site must be added to a list of acceptable sites under security settings for your web browser. This may require setup assistance from your facility’s IT department. The steps necessary to reconfigure this are also available in the document  Lab NBS Provider Web Installation (PDF 834KB)

For insurance/self-pay test kits, DSHS will bill the person or facility that orders kits. No bill is sent for Medicaid, CHIP or charity care newborn kits.

DSHS considered billing patients, but found that administrative costs would more than double the cost of the service. Minimizing administrative costs by charging providers for screening kits represented the most cost-effective approach.

Each screening test kit qualifies as a medical device. If a kit does not perform as it should, please notify the DSHS Newborn Screening Laboratory by email. DSHS will investigate, and kits found to be defective will be replaced free of charge.

For Insurance / Self-pay kits, healthcare providers will be required to purchase a replacement kit. Healthcare providers are responsible for ensuring the quality of specimens drawn. All screening kits for Medicaid-eligible, CHIP, and charity care newborns are provided free of charge to the healthcare provider.

Yes; however, there are caveats depending on the type of health plan.

Federally recommended newborn screenings are part of the comprehensive preventive health guidelines supported by the Health Resources and Services Administration (HRSA) for infants and children (Section 2713 of the Public Health Service Act). Health plans are required to cover screenings included in the HRSA-supported comprehensive guidelines without charging a co-payment, co-insurance, or deductible for plan years beginning on or after the date that is one year from the Secretary’s adoption of the condition for screening. However, there are many plans that were grandfathered and are not subject to this provision. Grandfathered health plans are typically plans issued before March 23, 2010.

The full list of federally-recommended newborn screening conditions:  https://www.hrsa.gov/advisory-committees/heritable-disorders/rusp/index.html.

At the state level, Texas Insurance Code 1367.003 requires Texas regulated health plans to provide certain health coverage for newborn children including newborn screening. This addition to the law became effective September 1, 2019 and only applies to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2020.

Doctors and health care facilities should work with health plans to ensure that newborn screening is included as a benefit in their contracts and that the health plans are aware of the cost for newborn screening.

DSHS will post the new cost to the DSHS NBS website and send out electronic notifications via the newborn screening distribution list, at minimum, 90 days prior to the effective date. 

1) Contact each health plan or insurance company to update your facility contracts.

2) Verify that Healthcare Common Procedure Coding System (HCPCS) code S3620 is updated to match the current cost for the screening kit.

3) Submit newborn screening claims using HCPCS code S3620.

Notes:

• HCPCS Code S3620: Newborn metabolic screening panel includes test kit and the laboratory tests specified by the state for inclusion in this panel. The healthcare provider may be responsible for additional costs not included in the cost of the test kit such as preparing and shipping the specimen to the DSHS Laboratory.

• CPT code 36416: Collection of capillary blood specimen, may also be used.

First, contact the health plan or insurance company to seek resolution.

  If no resolution is identified:

• For Texas Regulated Health Plans (Fully Insured and HMOs), contact:

Texas Department of Insurance.

https://www.tdi.texas.gov/hprovider/providercompl.html or 1-800-252-3439

• Self-Funded Plans regulated at the federal level (Most people who have health insurance in Texas have a self-funded plan), contact:

U. S. Department of Labor
Division of Technical Assistance and Inquiries
PWBA N5619

200 Constitution Ave. NW
Washington DC 20210
1-866-444-3272

• If insurance is provided by a school district, city, county or state government, a union, or church, work directly with the health plan.

Note: DSHS does not control how insurance companies operate or the reimbursement rates that are set.

TDI maintains resources for providers as does TMA and THA.

Other Resources:
Texas Department of Insurance: https://www.tdi.texas.gov/hprovider/providercompl.html

Texas Medical Association: https://www.texmed.org/newborn/
Texas Hospital Association: https://www.tha.org

DSHS must evaluate and adjust the fee of the newborn screening kit to recover the costs of: specimen processing, laboratory testing, and follow-up services. Most often the cost of these services increase due to adding disorders to the testing panel.  

The fee includes:  

• Direct costs for testing chemicals, supplies, labor, specimen collection kits, laboratory information management system (LIMS) and instrument maintenance

• Indirect costs for quality assurance, safety, building costs, courier service, administration, IT network and purchasing

•  Follow-up notification and care coordination for babies that have out-of-range laboratory results

 The fee is calculated using a procedure approved by the DSHS Chief Financial Officer. This method is used to determine all DSHS laboratory fees.

Yes. Both screens are required as listed in the Texas Administrative Code, Title 25 Section 37.56. Also, some of the disorders screened are more likely to be detected when the baby is more that one week old. 

DSHS Recommended Solution:

Use the Texas Newborn Screening Web Application (Neometrics). Benefits include:

• Provider can opt to enter patient demographic information (reduces miss interpretation of hand written information on the kits) and/or

• Search and view/print newborn screening result reports 24/7

Two ways the Texas Newborn Screening Web Application (Neometrics) helps you meet the new CAP requirement for NBS tracking:

1.    Electronically submit the demographic information for each newborn screen (NBS) specimen to the DSHS Laboratory. Once the specimen is received and scanned into the Laboratory Information Management System (LIMS), it will appear as “merged” in the provider’s Texas Newborn Screening Web Application account.

2.    Search for any newborn screening specimen submitted and view or print the result report. The DSHS Laboratory Quality Assurance Group has consulted with CAP and confirmed that healthcare providers can meet the specimen tracking requirement by confirming receipt of a result report for each specimen submitted. (Note: Demographic entry of specimens as described in above option is NOT needed in order to view/retrieve result reports.)

If you are not already a registered user of the Texas Newborn Screening Web Application, access the required forms and learn more information on the benefits of signing up here:

• /lab/remotedata.shtm
  
  Required forms:

• /laboratory-services/laboratory-testing-services-manual-forms-laboratory-fee-schedule

Alternate manual method:

NBS submitters can also opt to maintain a list of each NBS specimen submitted to the DSHS laboratory in the form of a manifest and reconcile the list upon receipt of the NBS result report. (A manifest does not need to be forwarded to the DSHS Laboratory.)

Yes, if necessary, but this practice is highly discouraged. It is preferred that each site request/receive its own submitter number.

All supplies, patient results, mailed correspondence, and alerts will be sent only to a single address for the Submitter ID number given. Separate submitter IDs for separate locations improves the timeline for submitter receipt of test result reports and ability to track supply shipments. It will also help ensure that supplies are received specifically by the site that ordered them.