Primary Care Coding Alert

Reader Question:

Stick to the Details to Separate 36415 from 36416

Published on Mon Jul 02, 2012

Question: Can we bill separately for 36416, or is the collection included in the E/M code?

Florida Subscriber

Answer: A few private payers reimburse for 36416 (Collection of capillary blood specimen [e.g., finger, heel, ear stick]), but many consider it part of the billed procedure. Check with your payers to learn their guidelines.

Caution: Don't confuse 36416 with 36415 (Collection of venous blood by venipuncture). Medicare and other insurers will typically pay for 36415 because it is a more extensive service. Be sure you know which collection method your technician performs before billing the encounter.

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