Chapter DHS 115

DHS 115.05   Laboratory tests.

DHS 115.055   Fees.

DHS 115.06   Criteria for adding or deleting conditions.

Ch. DHS 115 Note Note: Chapter HSS 115 was created as an emergency rule effective November 1, 1992. Chapter HSS 115 was renumbered ch. HFS 115 under s. 13.93 (2m) (b) 1., Stats., and corrections were made under s. 13.93 (2m) (b) 6. and 7., Stats, Register, May, 1998, No. 509. Chapter HFS 115 was renumbered chapter DHS 115 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.

DHS 115.01 DHS 115.01 Authority and purpose. This chapter is promulgated under the authority of ss. 253.13 and 227.11 (2), Stats., to specify the congenital disorders for which each newborn is screened and tested.

DHS 115.01 History History: Cr. Register, May, 1993, No. 449, eff. 6-1-93; correction made under s. 13.93 (2m) (b) 7., Stats., Register, July, 1995, No. 475; CR 14-074: am. Register July 2015 No. 715, eff. 8-1-15; EmR1920: emerg. am., eff. 10-15-19; CR 19-064: am Register December 2019 No. 768, eff. 1-1-20.

DHS 115.02 DHS 115.02 Applicability. This chapter applies to the attending physician licensed under ch. 448, Stats., nurse-midwife certified under s. 441.15, Stats., or other attendant at the birth of an infant born in Wisconsin, to the infant and the infant’s parents or guardian, and to the state laboratory.

DHS 115.02 History History: Cr. Register, May, 1993, No. 449, eff. 6-1-93; CR 14-074: am. Register July 2015 No. 715, eff. 8-1-15.

DHS 115.03 DHS 115.03 Definitions. In this chapter:

DHS 115.03(1) (1) “Congenital disorder” means a disorder present at birth, either inherited or due to an influence occurring during gestation up to birth.

DHS 115.03(2) (2) “Department” means the Wisconsin department of health services.

DHS 115.03(3) (3) “ICD-10-CM” means the International Classification of Diseases, 10th Revision, Clinical Modification.

DHS 115.03(4) (4) “Medical consultant” means a physician licensed to practice medicine or osteopathy under ch. 448, Stats., who has expertise in treatment of one or more of the conditions listed under s. DHS 115.04.

DHS 115.03(5) (5) “Metabolic disorder” means a disorder of the chemical processes that take place in the body.

DHS 115.03(6) (6) “Screening” means checking each member of a population to identify presumptive medical conditions that indicate that diagnostic testing for congenital or metabolic disorders is needed.

DHS 115.03(7) (7) “State laboratory” means the state laboratory of hygiene under s. 36.25 (11), Stats.

DHS 115.03 History History: Cr. Register, May, 1993, No. 449, eff. 6-1-93; correction in (2) made under s. 13.92 (4) (b) 6., Stats., Register January 2009 No. 637; CR 14-074: am. (3) Register July 2015 No. 715, eff. 10-1-15.

DHS 115.04 DHS 115.04 Congenital disorders. Pursuant to s. 253.13 (1), Stats., blood samples taken from each newborn shall be tested for all of the following conditions:

DHS 115.04(1) (1) 

DHS 115.04(1)(a) (a) Phenylketonuria (PKU), ICD-10-CM-E70.0.

DHS 115.04(1)(b) (b) Hyperphenylalaninemia, ICD-10-CM-E70.1.

DHS 115.04(2) (2) Galactosemia, ICD-10-CM-E74.21.

DHS 115.04(3) (3) Congenital hypothyroidism, ICD-10-CM-E03.1.

DHS 115.04(4) (4) Hemoglobinopathies, including all of the following:

DHS 115.04(4)(a) (a) Sickle cell disease, ICD-10-CM-D57.1.

DHS 115.04(4)(b) (b) Hemoglobin S-beta Thalassemia, ICD-10-CM-D57.40.

DHS 115.04(4)(c) (c) Hemoglobin SC disease, ICD-10-CM-D57.20.

DHS 115.04(4)(d) (d) Hemoglobin disease other, ICD-10-CM-D58.2.

DHS 115.04(5) (5) Biotinidase deficiency, ICD-10-CM-D81.810.

DHS 115.04(6) (6) Congenital adrenal hyperplasia, ICD-10-CM-E25.0.

DHS 115.04(7) (7) Cystic fibrosis, ICD-10-CM-E84.9.

DHS 115.04(8) (8) Fatty acid oxidation disorders, including all of the following:

DHS 115.04(8)(a) (a) Medium-chain acyl-CoA dehydrogenase deficiency, ICD-10-CM-E71.311.

DHS 115.04(8)(b) (b) Long-chain L-3-Hydroxy acyl-CoA dehydrogenase deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(c) (c) Very long-chain acyl-CoA dehydrogenase deficiency, ICD-10-CM-E71.310.

DHS 115.04(8)(cm) (cm) Carnitine palmitoyltransferase IA deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(d) (d) Carnitine palmitoyltransferase II deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(e) (e) Carnitine-acylcarnitine translocase deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(f) (f) Glutaric acidemia type II, ICD-10-CM-E71.313.

DHS 115.04(8)(g) (g) 2, 4-Dienoyl-CoA reductase deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(h) (h) Carnitine uptake defect, ICD-10-CM-E71.41.

DHS 115.04(8)(i) (i) Medium/short-chain hydroxy CoA dehydrogenase deficiency, ICD-10-CM-E71.318.

DHS 115.04(8)(j) (j) Medium-chain ketoacyl-CoA thiolase deficiency, ICD-10-CM-E71.318.

DHS 115.04(9) (9) Maple Syrup Urine Disease, ICD-10-CM-E71.0.

DHS 115.04(10) (10) Homocystinuria, ICD-10-CM-E72.11.

DHS 115.04(11) (11) Tyrosinemia types I, II, and III, ICD-10-CM-E70.21.

DHS 115.04(12) (12) Citrullinemia types I and II, ICD-10-CM-E72.23.

DHS 115.04(13) (13) Argininosuccinic acidura, ICD-10-CM-E72.22.

DHS 115.04(14) (14) Severe Combined Immunodeficiency and related conditions of immunodeficiency, ICD-10-CM-D81.9.

DHS 115.04(15) (15) Organic acidemias, including all of the following:

DHS 115.04(15)(a) (a) Glutaric acidemia type I, ICD-10-CM-E72.3.

DHS 115.04(15)(b) (b) Propionic acidemia, ICD-10-CM-E71.121.

DHS 115.04(15)(c) (c) Methylmalonic acidemia (CBL A, B, C, D; MUT), ICD-10-CM-E71.120.

DHS 115.04(15)(d) (d) Isovaleric acidemia, ICD-10-CM-E71.110.

DHS 115.04(15)(e) (e) 3-Methylcrotony1-CoA carboxylase deficiency, ICD-10-CM-E71.19.

DHS 115.04(15)(f) (f) Multiple carboxylase deficiency, ICD-10-CM-D81.818.

DHS 115.04(15)(g) (g) 3-Methylglutaconic aciduria, ICD-10-CM-E71.111.

DHS 115.04(15)(h) (h) beta-Ketothiolase deficiency, ICD-10-CM-E71.19.

DHS 115.04(15)(i) (i) 2-Methyl-3-hydroxbutyric aciduria, ICD-10-CM-
E71.19.

DHS 115.04(15)(j) (j) 3-Hydroxy-3-methylglutaric aciduria, ICD-10-CM-
E71.118.

DHS 115.04(15m) (15m) Spinal muscular atrophy, ICD-10-CM-G12.9.

DHS 115.04(16) (16) Critical congenital heart disease, including all of the following:

DHS 115.04(16)(a) (a)

DHS 115.04(16)(a)1. 1. Coarctation of the aorta, ICD-10-CM-Q25.1.

DHS 115.04(16)(a)2. 2. Atresia of aorta, ICD-10-CM-Q25.2.

DHS 115.04(16)(a)3. 3. Stenosis of aorta, ICD-10-CM-Q25.3.

DHS 115.04(16)(b) (b)

DHS 115.04(16)(b)1. 1. Double outlet right ventricle, ICD-10-CM-Q20.1.

DHS 115.04(16)(b)2. 2. Double outlet left ventricle, ICD-10-CM-Q20.2.

DHS 115.04(16)(c) (c) Ebstein’s anomaly, ICD-10-CM-Q22.5.

DHS 115.04(16)(d) (d)

DHS 115.04(16)(d)1. 1. Hypoplastic left heart syndrome ICD-10-CM-Q23.4.

DHS 115.04(16)(d)2. 2. Congenital mitral stenosis or atresia, ICD-10-CM-Q23.2.

DHS 115.04(16)(e) (e)

DHS 115.04(16)(e)1. 1. Interrupted aortic arch, ICD-10-CM-Q25.4.

DHS 115.04(16)(e)2. 2. Atresia of aorta, ICD-10-CM-Q25.2.

DHS 115.04(16)(e)3. 3. Stenosis of aorta, ICD-10-CM-Q25.3.

DHS 115.04(16)(f) (f)

DHS 115.04(16)(f)1. 1. Pulmonary valve atresia, ICD-10-CM-Q22.0.

DHS 115.04(16)(f)2. 2. Other congenital malformations of the pulmonary valve, ICD-10-CM-Q22.3.

DHS 115.04(16)(f)3. 3. Atresia of pulmonary artery, ICD-10-CM-Q25.5.

DHS 115.04(16)(g) (g) Single ventricle heart disease variants other than HLHS, including all of the following:

DHS 115.04(16)(g)1. 1. Hypoplastic right heart syndrome, ICD-10-CM-Q22.6.

DHS 115.04(16)(g)2. 2. Other congenital malformations of the tricuspid valve ICD-10-CM-Q22.8.

DHS 115.04(16)(g)3. 3. Congenital malformations of the tricuspid valve unspecified, ICD-10-CM-Q22.9.

DHS 115.04(16)(g)4. 4. Double inlet ventricle, ICD-10-CM-Q20.4.

DHS 115.04(16)(h) (h) Tetralogy of fallot, ICD-10-CM-Q21.3.

DHS 115.04(16)(i) (i)