Pediatric Coding Alert
Stick to This Code for PKU Heel Pokes
Question: Our provider office performs second and third newborn phenylketonuria (PKU) screens in our office. We complete a PKU screening card with a heel poke and we send it to the health department. Should we bill S3620 or 84030 to the insurance even though we didn’t run any tests? AAPC Forum Participant Answer: The code you bill for this service will depend on what, exactly, your provider does. To bill S3620 (Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-D; phenylanine (PKU); and thyroxine, total)), your office will have to perform an entire metabolic screening test on the newborn. You would use CPT® code 84030 (Phenylalanine [PKU], blood) if your office is only running the PKU portion of the screen. But if you are not running any test and simply collecting the blood sample to send out for the test, you’ll use 36416 (Collection of capillary blood specimen (eg, finger, heel, ear stick)).
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Stick to This Code for PKU Heel Pokes
Question: Our provider office performs second and third newborn phenylketonuria (PKU) screens in our office. We [...]
