tci ED Coding & Reimbursement Alert - 2018 Issue 9

Reader Question: Age Can Drive Venipuncture Codes

Question: I know that age is one of the factors that differentiates between the venipuncture codes, but what else is the difference between 36400-36410, 36420-36425, and 36415? And how do these procedures differ from 99195? Supercoder.com Subscriber Answer: Perhaps the first, and most important, difference between the codes lies in the qualifications of the provider that can administer them. Per CPT® guidelines, the first four codes you list can only be administered by a “physician or other qualified health care professional,” which CPT® defines as: “An individual who is qualified by education, training, licensure/regulation...

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