MedicaidBilling CodesMedium impact
Newsletter Vol. 12, No. 71
New Jersey Medicaid·NJ · Pediatrics, Pathology·Provider Notice
Effective date
Jul 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid and NJFC fee-for-service programs now reimburse independent clinical laboratories for pediatric lead screening using filter paper blood lead testing (ICP/MS method) at a maximum allowance of $8.00 per test under HCPCS code 83655. Physicians and clinics must use CPT code 36415 for specimen collection. This applies to claims with service dates on or after July 1, 2002.
Action Required
By July 1, 2002: Billing team must configure system to reimburse HCPCS code 83655 at $8.00 maximum allowance for independent clinical laboratories submitting pediatric lead screening claims to New Jersey Medicaid and NJFC. Ensure providers and certified nurse practitioners use CPT code 36415 when billing for specimen collection on encounter forms and billing system. Communicate to independent clinical laboratories and hospital laboratories that the new test methodology is available for reimbursement. Update internal fee schedule documentation. Failure to use correct codes will result in claim denials or payment delays.