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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : Appendix A. THSteps Forms : A.5 Tuberculosis Screening and Guidelines

The screening tool for tuberculosis (TB) exposure risk is to be used annually to determine the need for tuberculin skin testing.
The questions in the screening tool are intended as a minimum screen. Follow-up questions may be necessary to clarify hesitant or ambiguous responses. Questions specific to TB exposure risks in the client’s community may need to be added.
The following applies for tuberculin screening and skin testing:
In the case of the client for whom an answer in the past of “Yes” or “I don’t know” prompted a skin test, which was negative, the skin test may not have to be repeated annually.
The decision to administer a skin test must be made by the medical provider based upon an assessment of the possibility of exposure. A negative tuberculin skin test never excludes tuberculosis infection or active disease.
Bacillus of Calmette and Guérin (BCG) vaccinated clients should also have the screening tool administered annually. Previous BCG vaccination is not a contraindication to tuberculin skin testing. Positive tuberculin skin tests in BCG vaccinated children are interpreted using the same guidelines used for non-BCG vaccinated children.
Clients who have had a positive TB skin test in the past (whether treated or not), should be re-evaluated at least annually by a physician for signs and symptoms of TB.
Care of clients who are newly discovered to be tuberculin skin test positive includes:
Refer to:
“Frequently Asked Questions About TB” on the DSHS website at for information about assessing a child’s risk of TB exposure, providers can refer to
The TVFC Provider Manual, Forms, & Resources web page on the DSHS website at for the Patient Eligibility Screening Record (Bilingual), Questions & Answers about TVFC, and additional information.

Texas Medicaid & Healthcare Partnership
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