Any suggestions??
-We coded 99195 (Phlebotomy,therapeutic) and 76937(US Guide, vascular access, add on) Medicare is constantly denying this saying 99195 can only be done by in an office(we are sub-contracted with the hospital inpt/outpt/ the reading radiologists) And since we are in a "hospital setting" it is denied. And 76937 is not billable with 99195 obviously.
Patient is having this done because of polycythemia vera (238.4) Any and all suggestions are greatly appreciated! I am definitley stumped on this one.


Ultrasound guidance was required due to poor peripheral access. Using ultrasound guidance the right basilic vein was found to be patent and compressible. The approach was prepped with sterile alcohol solution a 16 gauge needle was advanced under ultrasound guidance into the right basilic vein with the tip of the needle confirmed in the vessel with ultrasound imaging. 350cc of blood was then removed by gravity drainage.

At the conclusion of the procedure all needles were removed. Good hemostasis was achieved and the patient tolerated the procedure well without evidence of immediate complication.

IMPRESSION: Ultrasound guided phlebotomy with removal 350cc of blood.