Question: Our vascular office performs blooddraws and analysis for a local hospital. Can we bill for a lab draw in an office setting, and if so, what codes should we use?
Answer: If you’re sending your patients to an outside lab for both the blood draw and testing, you cannot report any blood draw codes. If your office collects the blood, you have two coding options, depending on the next step.
Option 1: Since it sounds like your practice has its own laboratory to perform blood tests, you can report 36415 (Collection of venous blood by venipuncture) for the venipuncture, assuming that the lab has Clinical Laboratory Improvement Amendments (CLIA) certification.
Option 2: If the collected blood specimen goes to an outside lab for testing, you should report 36415 for the blood draw and add modifier 90 (Reference [outside] laboratory).
Also keep in mind that most Medicare carriers allow one collection fee for each patient encounter, regardless of the number of specimens drawn. If an E/M service is provided and billed, most payers will bundle 36415 into the E/M service.
Finally, be sure to document the blood draw. All services administered to the patient, including the blood draw, must be documented in the patient’s medical record.
@ Medical Office Billing & Collections Alert. Editor: Leesa A. Israel, CPC, CUC, CMBS
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