ED Coding and Reimbursement Alert

Reader Questions:

Physician Involvement Drives Blood Draw Coding

Question: Our physician ordered an arterial blood draw, which the hospital staff performed. On the claim, I reported 36600 for the service but got a denial. What did I do wrong?

Minnesota Subscriber

Answer: You should not have coded for the blood draw, since your physician did not perform the procedure. In order for the ED physician to bill 36600 (Arterial puncture, withdrawal of blood for diagnosis), the operative notes must show that the physician performed the draw.

If your physician did not perform the stick and blood draw, you cannot code for it. The hospital gets to code for it, because its staff performed the procedure.

-- Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.

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