Wiki Needs help understanding 99000 vs. 36415

[Wendy.J.1124]

Hi: I really need help to understand the difference of when to use these two codes. I understand the basics on each CPT code;however, please clarify for me: 'Isn't supposed to be that I have to enter both codes everytime there is Phlebotomy done? or is it that it depends on what kind of labs that are done at the time of visit?' Thanks for your help.

 

[kengel1975]

36415 vs 99000

Depends on the labs being sent. If your nurse or provider is drawing blood and sending to the lab both would be used.
If they are doing swabs of say the throat or mouth, etc, then only 99000 would be used when that is sent to the lab to be processed.

 

[Kate Tierney]

36415 is for a venipuncture, (technically a surgery code) and 99000 is for handling/conveyance of a specimen to a lab. Many payors don't reimburse for the handling of a specimen - it depends on the carrier. These aren't codes that are "always" used whenever a phlebotomy is done - if the blood tests are done in the office, you would certainly not use 99000, and you could use the handling code for specimens other than blood. When there is a blood draw done in the office, and the specimen is sent to an outside lab, you will want to check with the carrier about which codes they will reimburse.

 

[Wendy.J.1124]

Thanks so much for your answer. It does clarify a lot for me.