Anesthesia Coding Alert

Question: How do I code for venipuncture when anesthesiologist is called to perform a difficult stick?

Ohio Subscriber

Answer: CPT® helped answer this question by expanding the descriptors for two common venipuncture codes a few years ago.

• 36400 (Venipuncture, under age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein) -- By including the distinction of necessitating the skill of a physician or other qualified health care professional, CPT® clarifies that this code is for special circumstances, not routine sticks. The change also applies to indented codes 36405* (... scalp vein) and 36406 (... other vein). Even with the provider-specific wording, you’ll still be reimbursed two units for the code.
• 36410 (Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional [separate procedure],, for diagnostic or therapeutic purposes [not to be used for routine venipuncture]) -- This code previously stated that it was for “child over age 3 years or adult.” The updated wording simply clarifies that the code applies to anyone over age 3, not just young children or adults. 
• 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure) – CPT® really expanded this descriptor from its previous wording of “Postoperative follow-up visit, included in global service.” Some coders believe that CPT® changed it to prevent people from billing 99024 for office visits. Plus, adding “global service” to the descriptor makes it clear that this is a non-billable service.