Routine Venipuncture/Capillary Blood Collection S9529 Routine venipuncture for collection of specimen (s), single home bound, nursing home, or skilled nursing facility patientģ6591 Collection of blood specimen from a completely implantable venous access deviceģ6592 Collection of blood specimen using established central or peripheral venous catheterĪ. G0471 Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a SNF or by a laboratory on behalf of a HHA
The following codes have been added as mutually exclusive to 36415: 82948–blood glucose, reagent strip, 85013–spun hematocrit, 85014–hematocrit, 85610–Prothrombin time, 83036– glycated hemoglobin, and 86318 –immunoassay for infectious agent by reagent strip when submitted with the modifier QW.Ĭodes eligible for separate reimbursement when reported with a laboratory service: Code Descriptionģ6415 Collection of venous blood by venipunctureģ6416 Collection of capillary blood specimen (e.g., finger, heel, ear stick) Any blood test obtained by heel or finger stick will post a mutually exclusive edit with 36415 – venipuncture. In addition, HCPCS code G0471 for the collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (SNF) or by a laboratory on behalf of a home health agency (HHA) collected by a laboratory technician that is employed by the laboratory that is performing the test will be eligible for separate reimbursement when reported with a laboratory service.Ī specimen collection fee is limited only to venipuncture specimens drawn under the supervision of a physician to be sent outside of the office for processing. (See also our Frequency Editing Reimbursement Policy.) The frequency limit will also apply to any combination of these codes reported on the same date of service for the same member by the same provider. Unless an additional routine venipuncture/capillary blood collection is clinically necessary, the frequency limit for any of these services is once per member, per provider, per date of service. Routine Venipuncture/Capillary Blood Collection Routine venipuncture CPT codes 36415 and S9529 and capillary blood collection code 36416, are eligible for separate reimbursement when reported with an E/M and/or a laboratory service. Routine Venipuncture and the Collection of Blood Specimen from BCBSĪ.
This policy addresses the Health Plan’s reimbursement policies pertaining to clinical laboratory and related laboratory services (e.g., venipuncture and the handling and conveyance of the specimen to the laboratory) for professional provider claims submitted on a Form CMS-1500, whether performed in a provider’s office, a hospital laboratory, or an independent laboratory Please refer to the coding section of this policy for the procedure code most applicable to the method of blood withdrawal. The most common method and site of venipuncture is the insertion of a needle into the cubital vein of the anterior forearm at the elbow fold. There are several different methods for the collection of a blood sample. Venipuncture is the process of withdrawing a sample of blood for the purpose of analysis or testing. The most common method and site of venipuncture is the insertion of a needle into the cubital vein of the anterior forearm at the elbow foldĬollection of a capillary blood specimen (36416) or of venous blood from an existing access line or by venipuncture that does not require a physician’s skill or a cutdown is considered “routine venipuncture Venipuncture is the most common method used to obtain blood samples for blood or serum lab procedures, and is sometimes referred to as a “blood draw.” Venipuncture or phlebotomy is the puncture of a vein with a needle to withdraw blood. P96l5 – Catheterization for collection of specimen(s) 36415 Collection of venous blood by venipuncture – Fee schedule amount $3.10 – Private insurance pay upto $15ģ6416 Collection of capillary blood specimen (eg, finger, heel, ear stick) Fee schedule amount $3.1