Health Information Management

Q&A: Has billing for venipuncture changed in 2014?

APCs Insider, June 6, 2014

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Q: We have been watching our payments from Medicare since all the lab bundling was instituted in the 2014 OPPS final rule. We noticed that we are not receiving $3 for venipuncture any longer on any claims. Did something change with that too?
A: CPT® code 36415 (collection of venous blood by venipuncture) is considered a lab service. As such, in prior years under the OPPS, this code was assigned status indicator A (services paid under fee schedule or payment system other than OPPS) and was reimbursed based on the laboratory fee schedule.
As part of the bundling of clinical laboratory services in CY 2014, the status indicator for CPT 36415 was changed to N (items and services packaged into APC rates).
When billed on a 13x bill type, the payment for the venipuncture will be bundled into the main services along with the lab tests. You should validate that you are receiving reimbursement when you bill lab services, including the venipuncture, on a 14x bill type.
Editor’s note: Andrea Clark, RHIA, CCS, CPCH, chairman and founder of Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.

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