We are a local health department that does a lot of blood draws and sends the blood to a lab to perform the tests. We have many Medicare clients that come in for the venipuncture only. With Medicare denying 36415 now we are essentially doing the work for free. Is anyone billing any other code? I have read that 99211 gets denied also. Thank you!
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Wiki Medicare & 36415
- Thread starter Heather$
- Start date
airart
Guru
Medicare and 36415
Here is the Medicare guidelines for billing claims for collection types.
Medicare Claims Processing Manual," Chapter 16, Section 60.1.4
60.1.4 - Coding Requirements for Specimen Collection
(Rev. 3056, Issued: 08-29-14, Effective: 04-01-14, Implementation: 12-01-14)
(Rev. 3056, Issued: 08-29-14, Effective: 04-01-14, Implementation: 12-01-14)
The following HCPCS codes and terminology must be used:
? 36415 ? Collection of venous blood by venipuncture.
? G0471 ? Collection of venous blood by venipuncture or urine sample by
catheterization from an individual in a skilled nursing facility (SNF) or by a
laboratory on behalf of a home health agency (HHA)
? P96l5 ? Catheterization for collection of specimen(s).
Here is the Medicare guidelines for billing claims for collection types.
Medicare Claims Processing Manual," Chapter 16, Section 60.1.4
60.1.4 - Coding Requirements for Specimen Collection
(Rev. 3056, Issued: 08-29-14, Effective: 04-01-14, Implementation: 12-01-14)
(Rev. 3056, Issued: 08-29-14, Effective: 04-01-14, Implementation: 12-01-14)
The following HCPCS codes and terminology must be used:
? 36415 ? Collection of venous blood by venipuncture.
? G0471 ? Collection of venous blood by venipuncture or urine sample by
catheterization from an individual in a skilled nursing facility (SNF) or by a
laboratory on behalf of a home health agency (HHA)
? P96l5 ? Catheterization for collection of specimen(s).
mitchellde
True Blue
It could be the dx code. You cannot use 99211 for a blood draw encounter. If the dx code is not covered for a blood draw the claim will deny.