tracylc10
Guest
Does there need to be documentation of the capillary blood draw in the chart note to bill for code 36416?
We have OB pt's that come in for their first trimester screening and are having a finger stick, but there is no documentation of this. When I was a MA, we had to document the finger stick when we did it. (ie; capillary blood draw right ring finger on 07/27/2016 at 10:30 am.)
I feel that if it was not documented, then we cannot bill code 36416.
Any thoughts on this?
We have OB pt's that come in for their first trimester screening and are having a finger stick, but there is no documentation of this. When I was a MA, we had to document the finger stick when we did it. (ie; capillary blood draw right ring finger on 07/27/2016 at 10:30 am.)
I feel that if it was not documented, then we cannot bill code 36416.
Any thoughts on this?