General Surgery Coding Alert

Question: How should I report routine venipuncture to Medicare?


California Subscriber
Answer: You should report 36415 (Collection of venous blood by venipuncture) to Medicare for your surgeon's routine venipuncture procedures. For 2005, CMS deleted G0001 (Routine venipuncture for collection of specimen[s]).

When reporting 36415, be sure to watch your reimbursement. In the 2005 HCPCS update file released late last year, Medicare gave 36415 a status indicator of "X," meaning the agency would not pay for the code. But that was a mistake, according to a CMS transmittal released on Nov. 5, 2004.

"[C]ode 36415 has now been activated to be payable by Medicare effective Jan. 1, 2005," the transmittal says. "Thus, the HCPCS coverage indicator should be corrected to 'C.' The status indicator for OPPS should be 'A.' "

But Medicare still doesn't pay for 36416 (Collection of capillary blood specimen [e.g., finger, heel, ear stick]), which you may report to private carriers for your physician's Coumadin finger sticks. Technical and coding advice for You Be the Coder and Reader Questions provided by Marcella Bucknam, CPC, CCS, CPC-H, CCS-P, HIM program coordinator at Clarkson College in Omaha, Neb.