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Pediatric Coding Alert

You Be the Coder:

Blood Draw

Published on Fri Sep 01, 2000

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.



Question: What code do we use when drawing blood on an infant under 3 years of age using an antecubital vein? Also, what range of reimbursement should we expect for that code?

South Carolina Subscriber


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.
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