IV start and collection of venous blood

dabroussard

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Lisa

I just checked that in my Correct Coding Editor (CCE) and it isnt causing an edit or a modifier requirement.
 

Lisa Bledsoe

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I didn't see one either. I'm running this around in circles in my head...I keep thinking that if you do the stick, draw the blood then place the IV in the same site, wouldn't that constitute multiple procedures and require a -51? I'm confusing myself...
 

relong

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We start IV's for chemotherapy and draw blood. We bill out the lab draw and the administration codes. Are you giving an infusion or injection? There is no modifier needed unless you bill out multiple administration codes, some require a 59. The actual starting of the IV is include in the service in our case.
 

Lisa Bledsoe

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They are actually doing an infusion, whether for hydration or treatment (in the Urgent Care setting). I think I am seeing this clearer now... Thanks for the help!:)
 

DeeCPCPNH

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It depends

If you are billing from a facility standpoint and you are drawing blood from an established IV or lock then it is not a venipuncture by definition and you should not code 36415. The nursing service would add value to your facility level. If you draw blood from the vein directly that is a venipuncture and you can bill the 36415 code. If you can access CPT assistant or code correct you can find this informaiton there.
 

Lisa Bledsoe

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Thank you for the help. The service is provided in our in-house urgent care. The nurse is actually puncturing the vein for the lab draw and then placing the IV cath for infusion (whether hydration or therapeutic, etc) as ordered by the UC physician. :)
 

jmehalich

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No can do

If you are placing a cath for infusion you cannot bill 36415 in additon to the procedure code.
 

brocha

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IV's and Blood draws

So if the procedure is IV infusion and it was decided to draw blood from the same catheter would you only use the IV infusion code?
 

Scottie

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I thought that code 36415 was for drawing for multiple labs from one site when they would get 1 or more tubes of blood. I see this code all day long and so far we have not put any modifiers with it.
 

mitchellde

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It is correct that if you insert the catherter for the IV and prior to placing th IV you sraw blood for the labs that you may bill only the IV infusion. When you do a venipuncuture for multiple labs, and you leave the needle in place and fill multiple tubes then you bill for only one venipuncture because that was what you did. In theoriginal question it appears that a venipuncture for blood collection was performed then the vein was accessed again and a catherter inserted for the purpose of and infusion, in this instance, you may bill for both, will a modifier be needed, depends on the payer but a 59 would show that these were two independent sticks.
 

Lisa Bledsoe

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Actually the vein is accessed once using supplies to start the IV but they draw blood before starting the infusion. You are right, depends on the carrier for modifier use.
 

mitchellde

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Ah then I misunderstood the original question, if the vein is accesed only once then you may bill for only one access so bill the infusion.
 
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