MedicaidBilling CodesMedium impact
Clarification to Web Announcement 3692: Attention Providers Serving Healthy Kids or Nevada Check Up Recipients: Lead Testing Guidance according to the American Academy of Pediatrics (AAP) Bright Future’s Periodicity Schedule
Nevada Medicaid·NV · Pediatrics, Family Medicine·Provider Announcement
Effective date
Oct 17, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid clarifies that blood collection codes 36415 (venous) and 36416 (capillary) cannot be billed together on the same date when performing blood lead tests (83655). Providers can still perform lead testing in-house with CLIA waiver or refer to external labs.
Action Required
Immediately: Billing team must update system edits to prevent billing both CPT 36415 and 36416 on the same date of service when billed with lead test code 83655. Review existing claims for potential denials and train staff on proper blood collection code selection for lead testing.