Wiki Lab 82948 with Veni 36416

[Lisa A]

Good Morning Everyone!

I have been asked to determine why insurance will not pay venipuncture 36416 with CPT 82948 Stick Assay of Blood Glucose in a CAH. Can anyone help me determine the reason(s) or where I might go to research.

I do not know anything about reimbursement in this setting.

Thank you in advance,
Lisa

 

[CodingKing]

36416 (Finger/heel stick) is an RBRVS status B code not reimbursable. Most payers will also bundle 36415 (true venipuncture) into lab procedures unless its the sole procedure performed. collection if the blood is an integral component of a blood test or a component of the E&M.

 

[Lisa A]

The facility is stating that this should not occur in a CAH and that it is a PPS rule.

Does the POS have any affect on it?