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E/M and venipuncture

  1. Default E/M and venipuncture
    Medical Coding Books
    Our billing company is telling us that we cannot ever bill for an office visit with a venipuncture. They say that the 36415 is an add-on code. They have been writing them all off. I know about the 99211 and a veinpuncture but we often bill for the following example:

    Patient presents with fatigue and the doctor wants to do blood work. We will charge a 99213 and a 36415.

    Does anyone have any documentation stating that it is acceptable to bill for both the office visit and the venipuncture on the same visit? I understand that some insurance companies will bundle them but I am having a hard time finding any documentation on Trailblazer or Medicare stating that the 36415 is not an add-on code. Please let me know if we are doing this wrong! Thanks for any help!

  2. #2
    I do not have any documentation to support this at hand, but we bill it all the time. It is absolutely acceptable.

  3. #3
    Columbia, MO
    Add on codes are designated in the CPT with a + next to the number so 36415 is not an add on code.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    It is valid to code the 36415 in addition to the E&M. But some payers do consider it inclusive and deny separate payment. But we code and bill it.

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