Oncology & Hematology Coding Alert

Answer: You do not report codes 36400 (Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein) – 36425 (Venipuncture, cutdown; age 1 or over) for therapeutic phlebotomy. These codes are for venipuncture your physician performs in the office. You select the right code based upon the method to collect the blood sample. 

 

For therapeutic phlebotomy, report code 99195 (Phlebotomy, therapeutic [separate procedure]).

 

What is therapeutic phlebotomy? A therapeutic phlebotomy is similar to blood donation except that it is done as a treatment approach. When done for polycythemia, it helps to reduce the blood cell mass. 

Watch out: If therapeutic phlebotomy is performed in an inpatient or outpatient setting, the hospital -- not the physician -- should bill it because the hospital provides the space, personnel to perform the service and necessary equipment.

 

Do not forget the diagnosis codes: For polycythemia, you submit the ICD-9 code 238.4 (Polycythemia vera). This maps to code D45 (Polycythemia vera) in ICD-10-CM.