Neurology & Pain Management Coding Alert

Question: One of our nurses asked if we can bill the insurance companies for a blood draw in the office that we will be sending to a laboratory for culture. Can we?

New Jersey Subscriber

Answer: You report code 36415 (Collection of venous blood by venipuncture) for the blood draw your RN has done.

Tip: Do not append modifier 63 (Procedure performed on infants less than 4 kg) with 36415.

Note: You may code may be used for routine venipuncture process. You may check your payer preferences. Some payers cover a separate blood collection fee, and some don't. Medicare will pay for blood collection by venipuncture, but not a fingerstick, while some payers cover both. Still others consider the blood collection service bundled with the laboratory tests.

RNs, in contrast to Nurse Practitioners, are considered to be "clinical staff members" rather than "other qualified healthcare professionals" in that they do not individually report professional services, you may bill this in the name of the doctor who in the office at the time of the blood draw.