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Under what circumstances can CPT® code 36415 for venipuncture be reported separately on an outpatient claim, and how does Medicare’s OPPS status indicator Q4 impact the packaging of this service?
Currently, code 36415, venipuncture, is assigned to OPPS status indicator Q4 (conditionally packaged laboratory tests). Generally speaking, this service will always be packaged into the more primary service on an outpatient claim. Per Medicare, only one specimen collection may be reported per date of service, unless two separate and distinct encounters occur on the same date of service (e.g., clinic visit requiring blood work and a visit to the ED later in the day also requiring blood work).
This question was answered in our Coding Essentials for Infusion & Injection Therapy Services. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.
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