Wiki 36415 Venipucture charge only?

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stathia_c

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I am questioning whether or not you can bill a venipunture (36415) charge without an office visit. The Medicare patients are having the blood drawn at the office and the specimen is sent to another facility for processing. I have tried to locate the information on the Medicare website and was unable to. At the facility that I work we have received payment in the past. But recently received denials. Any suggestions? Any help?
:confused:
 
Stathia, if you go to TrailBlazer's website, go to the Search field and type in "venipuncture." Then look at the doucment called Documentation Requirements for CPT code 99211 published February 2008. It indicates that code 99211 should not be used to bill Medicare "when drawing blood for laboratory analysis or when performing other diagtostic tests, whether or not a claim for the venipuncture of other diagnostic studdy test is submitted separately." Therefore, you can bill 36415 by itself. As to your denials, are you billing anything differently than the claims that were paid?

Zaida, CPC
 
We bill out 36415 daily without other services being provided and get reimbursed. I'd start looking at other reasons for denials.

Right before we switched carriers from Noridian to WPS, Noridian started denying all of our 36415. When I called they said it was a computer error.
 
Since you are sending the specimen out you might want to consider billing 99000 instead of 36415. That is what we do if labs are sent out.
 
CPT code 99000 is only used if you were picking up a specimen from the patients home for example. You are not able to be reimbursed if it is collected int he office setting. The handling is included in CPT 36415

Chronicles Billing inc
 
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