Wiki Pediatric Lead test and 36416

[heisner33]

One of the doctors I work with stated he found research that says that you are able to bill for the lead test CPT 83655 and also CPT 36416 for the finger stick in order to perform the lead test. When I go onto clinical editing tools that most of our payers use I see that 36416 is inclusive to 83655. Are any other offices billing these together? Anybody have any opinions on what my doctor found researching this? I honestly believe that the inclusive denial is correct with my understanding of the services being provided but I would love to hear what other offices or staff have to say about it.

Thank you

 

[hewitt]

Maybe allowed. Depends on commercial insurance carrier. Unfortunately, the best way to determine this is to contact each or bill each.

 

[smontague]

Not sure about lead, because we only bill the finger stick (36416) and send the blood out for processing, but we do something similar with our PT/INR patients. We bill the lab (85610-QW) and the finger stick (36416) and depending on the payer some will pay both charges and some consider them inclusive...we have found it to be worth billing at our office, but I guess it depends on what payers you are working with.

 

[ajgibson]

We bill both the finger stick and the lead test. I am the coder, so I am not sure sure if charges are being written off on the back end, but the billers have not come back to tell me they are being rejected!