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Medicare denial for 36415

  1. Question Medicare denial for 36415
    Medical Coding Books
    I am new to coding and I would like some direction with this question. We have been billing cpt code 36415 for our labs (83036, 80061,80053, etc...) and it is not being paid. I have found out through the forum that Medicare doesn't reimburse for it when it submitted with certain codes. When other coders/billers see this on an encounter do you remove it or leave it and send it through to see if they will reimburse? I would like to remove knowing it's not going to be paid. Please advise.

    Thank you,
    Lisa Nieft - CPC-A

  2. Default
    We get paid every time on 36415 - a whopping $3, minus 6 cents for sequestration

    One reason you may not be getting paid is if you are trying to bill 36415 (venipuncture) for an 83036 (fingerstick-type lab)

    Also, I have heard that some states/Medicare jurisdictions will not pay 36415 for FNPs working off their own NPI

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