Anesthesia Coding Alert

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

Ohio Subscriber

Answer: CPT^® includes several codes that might be appropriate, depending on the situation. They are:

• 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 healthcare profes­sional, CPT^® clarifies that this code is for special circumstances, not routine sticks. This 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 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) — This code underwent a big change several years ago when the descriptor expanded 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.