Internal Medicine Coding Alert

Question: When our phlebotomist draws blood from a patient, can we charge for the draw fee, 36415*, along with the lab test itself? For example, a CBC85025 (hemogram and platelet count, automated, and automated and complete differential WBC count [CBC])?

Anonymous CA Subscriber

Answer: You can provided the phlebotomist is employed by the practice or paid for by the practice, says Emily Hill, PA-C, managing partner with Strategic Healthcare Services, a consulting firm in Southport, NC.

They can do a draw fee plus the laboratory fee, she says. The lab charge is for the performance of a laboratory test, not for obtaining the specimen.

The CPT code for the blood draw is indeed 36415* (routine venipuncture or finger/heel/ear stick for collection of specimen[s]). However, for Medicare patients, you should use HCPCS code G0001 (routine venipuncture for collection of specimen[s]).

According to program memorandum AB-93-7, dated Dec. 1, 1993, from the Health Care Financing Administration (HCFA) to carriers, HCFA has created a new code G0001 that must appear on all bills for the administration of routine venipuncture for the collection of specimens. The new code will prevent billing for minimal specimen collection costs that cannot be paid.

Only one collection fee is permitted per each type of specimen, per patient encounter, regardless of the number of specimens drawn, adds Hill.