Lead Testing

Blood lead testing

Lead exposure is an ongoing health issue in our communities, with increasing media and public attention as more sources of contamination are recognized. Exposure to lead is a risk for multiple socio-economic and cultural groups in New Jersey due to multiple potential sources.

Screening rates for children tested for lead exposure 6 months to 26 months of age*

  • NJ lead screening rate: 39.2%
  • Middlesex County lead screening rate: 36.3%
  • Sussex County lead screening rate: 20.2%
  • Camden County lead screening rate: 32.1%
  • Essex County lead screening rate: 47.3%
  • Gloucester County lead screening rate: 22.8%
  • Cape May County lead screening rate: 25.9%

Physician adherence to testing guidelines and the assessment of risk holds the most promise for increasing the number of children tested. The State’s goal is at least 80% screening rate.

Resources to help you help our members – your patients

To help ensure all children are screened properly and timely, below are additional details on testing requirements and lead screening information to support your office staff in conducting lead screenings.

State requirements for lead screening

  • Every child in the NJ FamilyCare program (Medicaid), regardless of risk, must be tested between 9 months and 18 months of age, preferably at 12 months AND at 18-26 months of age preferably at 24 months.
  • Children between 24 and 72 months of age who have not previously had a blood lead test should be tested immediately regardless of the verbal risk assessment.

Verbal risk assessment

Providers should do a verbal risk assessment for lead exposure at every visit with children who are at 6 months of age and 72 months of age. The questions must include at least the following:

  • Does your child live in or regularly visit a house built before 1978? Does the house have chipping or peeling paint?
  • Was your child’s day care center/preschool/babysitter’s home built before 1978? Does the house have chipping or peeling paint?
  • Does your child live in or regularly visit a house built before 1978 with recent, ongoing, or planned renovation or remodeling?
  • Have any of your children or their playmates had lead poisoning?
  • Does your child frequently come in contact with an adult who works with lead? Examples include construction, welding, pottery, or other trades practiced in your community.
  • Do you give your child home or folk remedies that may contain lead?


  • If all answers are negative, risk is considered low for high exposure; all children at low risk need blood lead testing at the ages shown below.
  • If any answer is yes or “I don’t know”, risk is considered high; all children at high risk need testing immediately.
  • The questions must be asked at every subsequent visit since risk can change.

Our Lead Care Management Program

Children with elevated blood lead levels of 5ug/dL or greater should be referred to the Plan’s Lead Care Management Program, a free covered benefit for our members. The Lead Care Management Team will coordinate care with the local health departments in order to facilitate an environmental intervention to identify and remediate hazards. Our nurse will talk with families about their health concerns and goals and will create a personalized plan of care to help guide families to ongoing medical care and assistance.

You can refer children to the Plan by (1) calling Provider Services at 1-855-232-3596 or (2) by faxing the completed lead test(s) to the plan directly at 1-959-282-1622. Please include a note indicating that you are referring the member for Lead Care Management.

MedTox makes testing easier on you and your patients

MedTox, an in-network lab, has a means of measuring blood lead levels using a capillary (finger stick) blood sample and filter paper in the office. MedTox’s method of testing is a fast, less invasive and easy way to ensure members are tested before a member leaves your office. A MedTox test is also less burdensome to your office and more positively affects the number of children tested.

For more information on using the MedTox technique, please contact Joe Huffer with MedTox at 1-877-725-7241 or hufferj@labcorp.com. For more information about MedTox, visit medtox.com/services_filterpapertesting_clinicallaboratoryservices.aspx.

Below are the EPSDT lead screening CPT codes:

  • 83655 52* – Lead test
  • 36405 59** – Venipuncture for children under 3 years of age, scalp vein
  • 36406 59** – Venipuncture for children under 3 years of age, other vein
  • 36410 59** – Venipuncture for children 3 years and older, non-routine
  • 36415 59** – Venipuncture for children 3 years and older, routine
  • 36416 59** – Collection of capillary blood specimen (finger, heel, and ear stick)
  • 83655 – Lead test

*52 modifier is used when there is a reduced service

**59 modifier – is used for a distinct procedural service

Please send all testing results for Aetna Better Health of New Jersey members directly to our dedicated, secure fax line 1-959-282-1622.

Thank you for your continued to partnership to improve lead testing.

1Source: www26.state.nj.us/doh-shad/indicator/complete_profile/Pb_test_cov.html.