Results 1 to 5 of 5

36000 with 99195?

  1. #1
    Greenville, NC
    Default 36000 with 99195?
    Medical Coding Books
    Patient with hemochromatosis requires blood to be drawn off for ~30 minutes, 1 time a week for several weeks and then periodically once on mainetenance.

    99195 is what I am charging for therapeutic phlebotomy. Doc wants to also charge 36000 for the venous access to do the therapeutic phlebotomy. Is the 36000 included in the 99195 or should I bill both and use a modifier? If so, which modifier (51, 59, ?).

    Thanks for any help,

    Hunter Smith, CPC

  2. #2
    Columbia, MO
    The access is inclusive to the procedure.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Greenville, NC
    Default Thanks

    Thanks, exactly what I told them, just wanted another CPC to agree with me to confirm I was on the right track.


  4. #4
    Could you please advise what documentation is needed and is there a minimal amount of blood to be withdrawn

  5. Default
    It is correct that 99195 includes 36000. However, 99195 is considered to be a separate procedure. Here's an interesting extract from the Medicine Guidelines: Separate Procedures: Second paragraph: "However, when a procedure or service that is designated as a "separate procedure" is carried out independently or considered to be unrelated or distinct from other procedures/services provided at that time, it may be reported by itself, or in addition to other procedures/services by appending modifier 59 to the specific "separate procedure" code to indicate that the procedure is not considered to be a component of another procedure , but is a distinct independent procedure. This may represent a different session or patient encounter, etc. etc."
    I think this means that you should report 99195-59 and not just 99195 by itself.

Similar Threads

  1. 36000 with modifier 59
    By 08pancho in forum Emergency Department
    Replies: 2
    Last Post: 04-27-2015, 07:36 AM
  2. cpt 36000
    By N70QW in forum Interventional Radiology
    Replies: 1
    Last Post: 01-17-2014, 01:58 PM
  3. phlebotomy code 99195
    By mad_one80 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 09-06-2013, 01:46 PM
  4. 36000 vs 36410
    By in forum Emergency Department
    Replies: 0
    Last Post: 01-04-2013, 12:18 PM
  5. cpt 36000-When is it proper
    By lwertman in forum General Surgery
    Replies: 1
    Last Post: 04-02-2012, 08:58 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.