Q&A CPT 36415, replaced with 36410?

[Teresa]

Hi, I code cpt 36415 along with labs and have noticed that Medicare and most other carries, deny as global (considered routine & is not covered) except when billed with "Physicals", I have also noticed 36415 is not anywhere on cci edits however 36410 is. Is 36410 the preferred venipuncture code for lab draws now?

 

[Carolyn Heath]

I googled 36410 and found that it is for venipuncture that is performed on individuals over 3 years of age. It went on to say that the venipuncture requires a physician's skill and may be done for diagnostic or therapeutic purposes. 36415 is considered a routine venipuncture.

 

[Ruth Sheets]

This was also covered during the October 2013 Q&A Webinar. One key idea worth noting, in addition toe Carolyn Heath's points above, is that most payers will bundle 36415 into the E/M service. That may explain the denials, so it is worth checking with the payer's policies.

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