Pathology/Lab Coding Alert

Question: What is the correct code for phlebotomy services (blood draw)?

Nebraska Subscriber

Answer: That depends - different codes apply based on the payer and the type of blood draw. But you can choose the right code every time by following these two simple steps:

1. Determine whether the patient is a Medicare beneficiary. If you are billing Medicare for your lab's services, you have only one code available for blood collection: G0001 (Routine venipuncture for collection of specimen[s]). Law mandates that Medicare cover venipuncture but does not require coverage for collection of a capillary blood specimen (such as a finger or heel stick).

2. Identify whether the blood collection was from a vein or capillary. There are only two codes to choose from when you bill blood collection services to a private payer: 36415 (Collection of venous blood by venipuncture) and 36416 (Collection of capillary blood specimen [e.g., finger, heel, ear stick]). Selecting the right code is as simple as knowing the source of the collected specimen.

Remember that the lab can't code for the blood draw if you don't do it at the lab.