Pathology/Lab Coding Alert

Question: When our lab performs the blood draw as well as the lab test, such as CBC, can we separately code the draw or do payers include it in the lab test? If separate, which code should we use? Georgia Subscriber

Answer: You may separately report the blood draw service for a lab test, in most cases. Some payers consider the service bundled with the costs associated with the lab test, however, so you'll need to follow payer rules. Which code you use depends on the type of blood draw and who's doing it.

The most common code for a phlebotomist blood draw would be 36415 (Collection of venous blood by venipuncture).

You might also report 36416 (Collection of capillary blood specimen [e.g., finger, heel, or ear stick]). Beware -- Medicare won't pay for a capillary blood collection.

Most payers allow for one collection fee for each patient encounter, regardless of the number of specimens drawn. Even if you're drawing for multiple tests, such as a CBC (such as 85025, Blood count; complete [CBC], automated [Hgb, Hct, RBC, WBC and platelet count] and automated differential WBC count) and a basic metabolic panel (80047, Basic metabolic panel [Calcium, ionized]), treat the collections as a single encounter. You would report 36415 once per encounter.

Port draws are different: For a blood draw from an implanted device such as a port, CPT list 36591 (Collection of blood specimen from a completely implantable venous access device) or 36592 (Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified) for blood draw from a peripherally inserted central catheter (PICC) or peripheral catheter.

Caution: These are physician procedure codes that you should not use for phlebotomist blood collection services.