MedicaidDocumentationMedium impact
Screen Medicaid Members for Lead Exposure Before Their Second Birthday
BCBS New Mexico·NM · Pediatrics, Family Medicine·Government Programs
Effective date
May 21, 2026
We identified it
Jun 18, 2026
Summary
Blue Cross Blue Shield of New Mexico requires blood lead screening for all Medicaid children at 12 and 24 months of age, with catch-up testing for children 24-72 months with no previous screening. Specific CPT and ICD-10 codes must be used for proper billing and documentation.
Action Required
By May 21, 2026: Billing team must ensure proper coding for Medicaid lead screening using CPT 83655 for blood lead analysis, CPT 36415 for venipuncture, CPT 36416 for capillary collection, and ICD-10-CM R78.71 for abnormal lead levels. Providers must document all lead screening in medical records and ensure compliance with EPSDT requirements for children at 12 and 24 months.