Wiki billing 36415 with the lab tests

[kathleeng]

I work for an oncology/hematology office and we have our own lab. I also do the coding for our actual lab. We usually bill the 36415 for the draw along with the lab tests under the lab POS. It was recently brought to my attention that Blue Shield has been bundling 84153 with 36415, but not with any others (at least not that I'm aware of yet). I have found some information that states certain health plans do not allow the 36415 to be reimbursed with the lab cpt codes. I'm not quite sure how to determine when to bill or not, but I would like us to be doing things correctly across the board. BS stated to use the modifier 59 on 36415, but I don't believe that's the appropriate use of this modifier, and I don't want us to be doing something "just to get it paid". If it's not appropriate to bill the 36415, then I would think that we shouldn't be billing it with any insurances. Is anyone familiar with this?

 

[DumindaJ]

What are the other services billed?

 

[smontague]

I would add the 36415 any time a venipuncture is being performed. You should still include it even if you aren't getting reimbursed for it. The charge/code represents the work you're doing.