Wiki 36410 vs 36415

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mmoorer

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Hello All,

I bill for a Family Practice and we have had so many issues with the cpt codes 36410 and 36415. Can some one please break down the difference between these 2 codes; are they different if the reason for the blood draw is diagnostic vs. routine OR is the difference due to the level of skill needed to perform the blood draw ? Please help, I need some insight before I plead my case to the physicians. Thank You all in advance and have a great day ! :)

Melissa M, CPB
 
mmoorer said:
Hello All,

I bill for a Family Practice and we have had so many issues with the cpt codes 36410 and 36415. Can some one please break down the difference between these 2 codes; are they different if the reason for the blood draw is diagnostic vs. routine OR is the difference due to the level of skill needed to perform the blood draw ? Please help, I need some insight before I plead my case to the physicians. Thank You all in advance and have a great day ! :)

Melissa M, CPB
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36410 is if a nurse, phlebotomist ATTEMPTS (key word) to withdraw blood and the nurse is not able to successfully accomplish the task and they ask the doctor to come in and do the task. This is NOT the same thing as if a nurse or tech is simply not available. There has to be a failed attempt to use this code for the doctor to come in and attempt the withdraw.

36415 is if the nurse or phlebotomist is able to do with the draw.
 
cjhalk@yahoo.com thank you so much ! This is what I was thinking also, I just wanted to be sure. What confuses me the most is in the coder's desk reference the description of both codes does not mention anything about a failed attempt, the difference seems like one is used when a vein is punctured and blood is drawn (36410) and the other is used when the needle is inserted through the skin and OVER a vein to puncture blood vessels to withdraw blood. What do you think about this ?
 
the difference is the 36410 REQUIRES a physician skill and the 36415 does not. If you simple do not have a nurse or other skilled person to draw the blood and the physician is the only one that can perform this function you use the 36415. If the blood draw is so difficult that it requires the physician to be the one to perform the procedure that is when the 36410 is used. That is where the previous poster is using the logic of the failed attempts.
 
Thank you mitchellde for your insight as well ! So what I am gathering from both responses is the difference pertains to the level of skill required to perform the draw, thank you again for the responses I greatly appreciate it ! Now I can feel more confident about the use of these codes. Have a Great day !
 
36410

Hi guys,

We have a family practice physician who is a solo practitioner. He never had a nurse or a medical assistant. The doctor takes the vitals, does all EKGs, and always draws the blood in his office. Can I bill the 36410 code for venipuncture since the blood is always drawn by the doctor himself?

Thank you,

Bart
 
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