APCs Insider, august 10, 2012

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Q: ns am relatively brand-new to auditing and also when i look at my facilities insurance claims I view the venipuncture password (CPT password 36415) assigned on part bills however not ~ above all.All these insurance claims have activities services.Can you define what I need to look for when I carry out not check out the venipuncture password on the claim?


A: CPT password 36415 (collection of venous blood by venipuncture) is supplied when basic personnel execute a blood draw for the objective of laboratory testing.

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A specimen repertoire fee is enabled in situations such as drawing a blood sample v venipuncture (i.e., inserting into a vein a needle v syringe or vacutainer to draw the specimen) or collecting a pee sample by catheterization. A specimen collection fee is not permitted for blood samples wherein the cost of collecting the specimen is minimal (such as a throat culture or a regimen capillary puncture because that clotting or bleeding time)…… only one collection fee is permitted for each type of specimen because that each patience encounter, regardless of the number of specimens drawn. As soon as a series of specimens is required to complete a single test (e.g., glucose tolerance test), the collection is treated together a single encounter.
In some cases, the venipuncture is not charged due to the fact that nursing personnel will attract blood during the start of one IV line.When the blood specimen is taken throughout the begin of the IV line, the rod is contained in the initial organization for drug management and CPT code 36415 is not reported additionally.
When the blood is attracted from a saline lock, (for example, in the ED), some facilities select to encompass this as component of the individual source mapping criteria. Review your separation, personal, instance facility’s criteria to recognize whether this is had in stimulate to catch the sources involved.
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity solutions at health and wellness Revenue Assurance Associates, Inc., in Plantation, Fla., answer this question.

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