Pediatric Coding Alert

Answer: For a child under the age of 3, venipuncture using either a needle or catheter drawing from an antecubital vein would necessitate the use of CPT 36406 (venipuncture, under age 3 years; other vein). Actually, this code would apply for a blood draw for any vein other than a femoral, jugular or sagittal sinuses (36400) or scalp vein (36405).

Reimbursement may vary from state to state and plan to plan. We would anticipate that some insurance plans would consider this as part of the visit code and bundle it with the evaluation and management (E/M) code. When billing, provide documentation for the service, and appeal if the plans deny the charge.