Coders: Report 36415 For Lab Draws

By Author: Nancy Rose
Total Articles: 53
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Depending on the next step, you have two options.


Question: Our vascular office carries out blood draws and analysis for a local hospital. Can we bill for a lab draw in an office setting, and if so, what codes should we go for?


Georgia Subscriber


Answer: If you are sending your patients to an outside lab for both the blood draw and testing, you can't report any blood draw codes. If your office gathers the blood, you have two coding options, depending on the next step.


Here is Option 1: Since it sounds like your practice has its own laboratory to carry out blood tests, you can go for 36415 (Collection of venous blood by venipuncture) for the venipuncture, thinking that the lab has Clinical laboratory Improvement Amendments (CLIA) credential.


Here is Option 2: If the collected blood specimen goes to an outside lab for testing, you should go for 36415 for the blood draw and append modifier 90 (Reference (outside) laboratory).


What's more, keep in mind that most Medicare carriers allow one collection fee for each ...
... patient encounter, irrespective of the number of specimens drawn. If an evaluation & management (E/M) service is provided and billed, most payers will bundle 36415 into the evaluation & management service.


Lastly, see to it that you document the blood draw. All the services administered to the patient, including the blood draw, must be documented in the patient's medical record.


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