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84030, 36416, and 81002

  1. Question 84030, 36416, and 81002
    Medical Coding Books
    Hello! I have a question on the best way to bill for the PKU and a UA. For the PKU we do the blood draw and prep the sample then send it off to a lab. We use the 36416 for the blood draw. Should we also be billing the 84030 for the PKU as well or just the code for the blood draw? Also i was wondering if any one has any tips or a better way to bill for the UA (81002). We are getting denials on these codes, but not consistantly. More are being denied now than paid. The denial reasons are inconsistant as well. Any ideas? Thanks for any help!

  2. #2
    Hi paintgirl! Here at our pedi office we also do the draw for the pku and bill for that only. We do not bill the actual test because we are not performing it. As for the ua 81002 we don't do that test we do the 81001 and many insurance companies do not pay for that test. They just roll it into the visit so we usually end up writing it off. Hope that helps

  3. Question
    Hello! Thanks for the reply. I had a couple more questions for you. What dx are you using for the draw for the PKU? Do you get paid for it? What modifier are you using if any?
    Thanks! Kristi.

  4. #4
    We use the v77.3 for the dx but we don't always get paid as I said some insurance companies roll the draw into the visit but some will pay it. I do not use a modifier.

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