Wiki Venipuncture Billing

[Tara0513]

Hello! I am looking for clarification on billing venipuncture. I work for an independent laboratory, and my boss wants to know if we can bill for the venipuncture? We are processing the specimens in our lab, and I was under the impression that we should not be billing for the venipuncture since that is included in the payment for the specimen processing. Can someone please help me out with if we can bill.

 

[lgardner]

Is the venipuncture being done in your lab?
or are the specimens sent to your lab?

 

[giatarab1]

lgardner has the right questions. You stated that they are "processing" the specimens. Please clarify first if your lab staff is actually drawing the blood. Usually, if the veni is done at a clinic or in a facility you can't bill any other services on that same date in order for a veni to be paid. I believe Independent labs are different if you actually draw the blood in your laboratory. I do know that mobile lab "homebound" patient services are allowed to bill the veni and the tests; this is also for a independent lab and Medicare pays for them, some commercial payors do not. You can get more clarification in writing by going onto cms.gov and typing in laboratory manual. I've attached 2022 guidelines that I pulled for a client last year- (it does have some text notes and highlights) - I would be sure to pull the 2023 guidelines if they have it shown as updated. Either way, the answer you are looking for -I believe- is in section 60.1. Hope this helps!