Wiki venipuncture

[samorn]

Hi

I read in CMS that 36415 venipuncture is not covered by Medicare, would any one happen to know other wise or if I am reading this incorrectly. Would an ABN be required or is there an LCD? Any help is very much appreciated.

TIA

 

[rthames052006]

Hi

I read in CMS that 36415 venipuncture is not covered by Medicare, would any one happen to know other wise or if I am reading this incorrectly. Would an ABN be required or is there an LCD? Any help is very much appreciated.

TIA

Where did you read this? The offices I work for bill venipunctures on a regular basis and we have no problem getting paid by Medicare. Are you getting denials? If so I'd call Medicare and get a rep on the phone to discuss the issue.

 

[LLovett]

For 2005, the clinical laboratory fee schedule will not include code G0001 and will include code 36415
Collection of venous blood by venipuncture. Code 36415 was released as not payable by Medicare in the
2005 HCPCS update file. However, code 36415 has now been activated to be payable by Medicare
effective January 1, 2005. Thus, the HCPCS coverage indicator should be corrected to "C". The status
indicator for OPPS should be "A". CPT code 36416 relating to a capillary specimen collection remains
not payable by Medicare as a separate service.

http://www.cms.hhs.gov/Transmittals/downloads/r363cp.pdf

http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA6070.pdf

The first link is where the above came from, the 2nd link is regarding 2009 fees. Page 2 under pricing information.

Hope this helps,

Laura, CPC