How To Use CPT Code 36400

CPT 36400 describes the procedure of venipuncture for patients younger than 3 years old, requiring the skill of a physician or other qualified healthcare professional. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36400?

CPT 36400 is a code used to describe the procedure of venipuncture for patients who are younger than 3 years old. This procedure requires the skill of a physician or other qualified healthcare professional. Venipuncture involves puncturing a vein to collect a blood sample or provide intravenous infusion of drugs. The most common sites for venipuncture are the jugular, femoral, median cubital, and scalp veins. However, for patients younger than 3 years old, the preferred site is the scalp vein due to its prominence and ease of access.

2. Official Description

The official description of CPT code 36400 is: ‘Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein.’

3. Procedure

1. The physician or other qualified healthcare professional places the patient in a suitable position to ensure normal blood flow.
2. A tourniquet is applied a couple of inches above the site of puncture.
3. The skin of the puncture site is cleaned.
4. A needle attached to a flexible tube is inserted through the skin into the vein at an angle of approximately 20° or less.
5. When the vein is entered, the blood starts flowing into the needle.
6. The needle is inserted slowly and carefully to avoid piercing the posterior wall of the vein.
7. After the desired procedure of collecting blood or infusing drugs is complete, the needle is withdrawn.
8. The site of puncture is pressed with surgical wool to prevent bleeding.

4. Qualifying circumstances

CPT 36400 is used when the venipuncture procedure is performed on patients younger than 3 years old and requires the direct involvement of a physician or other qualified healthcare professional. The puncture is done on the femoral or jugular vein. It is important to note that this code should not be used for routine venipuncture procedures, which are reported using different codes such as 36415 or S9529.

5. When to use CPT code 36400

CPT code 36400 should be used when a physician or other qualified healthcare professional performs a venipuncture procedure on a patient younger than 3 years old. This code is specifically for punctures done on the femoral or jugular vein. It should not be used for routine venipuncture procedures.

6. Documentation requirements

To support a claim for CPT code 36400, the following documentation is required:

• Patient’s age and the need for venipuncture
• Specific vein punctured (femoral or jugular)
• Date and time of the procedure
• Details of the procedure, including any complications or special considerations
• Signature of the physician or other qualified healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 36400, ensure that the procedure is performed by a physician or other qualified healthcare professional and that it is done on the femoral or jugular vein in a patient younger than 3 years old. It is important to note that this code should not be reported for routine venipuncture procedures. Additional tips for reporting CPT code 36400 may include considerations for specific payers or documentation requirements.

8. Historical information

CPT code 36400 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been several changes to the code, including updates to the description and clarification of the qualifying circumstances.

9. Examples

1. A physician performing a venipuncture on a 2-year-old patient’s femoral vein to collect a blood sample for laboratory testing.
2. A qualified healthcare professional performing a venipuncture on a 1-year-old patient’s jugular vein to administer intravenous medication.
3. A physician performing a venipuncture on a 6-month-old patient’s femoral vein to provide intravenous fluid therapy.
4. A qualified healthcare professional performing a venipuncture on a 2-year-old patient’s jugular vein to collect a blood sample for diagnostic purposes.
5. A physician performing a venipuncture on a 3-year-old patient’s femoral vein to administer anesthesia for a surgical procedure.
6. A qualified healthcare professional performing a venipuncture on a 1-year-old patient’s jugular vein to collect a blood sample for genetic testing.
7. A physician performing a venipuncture on a 2-year-old patient’s femoral vein to provide intravenous nutrition.
8. A qualified healthcare professional performing a venipuncture on a 6-month-old patient’s jugular vein to administer a contrast agent for imaging studies.
9. A physician performing a venipuncture on a 1-year-old patient’s femoral vein to collect a blood sample for allergy testing.
10. A qualified healthcare professional performing a venipuncture on a 3-year-old patient’s jugular vein to administer intravenous antibiotics.