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venipuncture

  1. #1
    Default venipuncture
    Medical Coding Books
    Hi

    I read in CMS that 36415 venipuncture is not covered by Medicare, would any one happen to know other wise or if I am reading this incorrectly. Would an ABN be required or is there an LCD? Any help is very much appreciated.

    TIA

  2. #2
    Default
    Quote Originally Posted by samorn View Post
    Hi

    I read in CMS that 36415 venipuncture is not covered by Medicare, would any one happen to know other wise or if I am reading this incorrectly. Would an ABN be required or is there an LCD? Any help is very much appreciated.

    TIA
    Where did you read this? The offices I work for bill venipunctures on a regular basis and we have no problem getting paid by Medicare. Are you getting denials? If so I'd call Medicare and get a rep on the phone to discuss the issue.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  3. #3
    Default
    For 2005, the clinical laboratory fee schedule will not include code G0001 and will include code 36415
    Collection of venous blood by venipuncture. Code 36415 was released as not payable by Medicare in the
    2005 HCPCS update file. However, code 36415 has now been activated to be payable by Medicare
    effective January 1, 2005. Thus, the HCPCS coverage indicator should be corrected to "C". The status
    indicator for OPPS should be "A". CPT code 36416 relating to a capillary specimen collection remains
    not payable by Medicare as a separate service.

    http://www.cms.hhs.gov/Transmittals/...ads/r363cp.pdf

    http://www.cms.hhs.gov/ContractorLea...ads/JA6070.pdf

    The first link is where the above came from, the 2nd link is regarding 2009 fees. Page 2 under pricing information.

    Hope this helps,

    Laura, CPC

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