Gastroenterology Coding Alert

Question: Our office is having trouble with claims when the gastroenterologist collects blood samples and sends them to an outside lab for analysis. How can we prevent these denials?

Maryland Subscriber

Answer: Your lack of success may have to do with your diagnosis coding or lack thereof. When the gastroen-terologist procures blood samples for off-site lab work, you should report 36415 (Collection of venous blood by venipuncture) with the most specific ICD-9 codes you can apply -- don't expect the lab to provide the codes.

Some offices erroneously wait for labs to assign diagnosis codes for blood tests. But since physicians can sometimes report services related to diagnostic lab tests, physicians need to provide the reason for the test; the documentation in the medical record provides that reason. (According to Medicare Program Memorandum AB-01-144, the laboratory cannot assign a diagnosis code unless a physician interprets the results of the test.)