CPT 36415, cpt code 36415, 36415 cpt code

CPT Code 36415 | Collection Of Venous Blood By Venipuncture (2023)

Report CPT 36415 if a provider collected a blood sample with a needle from the patient’s vein. 

What Is CPT Code 36415?

CPT 36415 can be billed for inserting a needle into the patient’s vein to collect a blood sample.

Description

The CPT book describes CPT 36415 as: “Collection of venous blood by venipuncture.”

Procedure

The provider cleanses the venipuncture site on the upper arm or elbow with an appropriate antiseptic, usually 70% alcohol.

He allows the area to dry. 

Next, the provider wraps an elastic band around the upper arm so that the vein at the arm swells.

Next, the provider inserts a needle slowly into the vein, taking care not to puncture the posterior wall of the vein.

He draws around 5 mL of blood into a collection tube. Then he removes the needle and applies direct pressure onto the puncture site to stop the bleeding.

How To Use CPT 36415

CPT code 36415 can not be billed with modifier 63.

Example 1

A 10-month-old patient is provided with critical care face-to-face services by the provider, and venipuncture services are performed.

In the above case, a patient’s age is ten months, and he is critically ill. Blood sampling is taken to find out the diagnosis.

The billing of the venipuncture code 36415 is not valid in this case. Therefore, the venipuncture code must be billed separately.

Example 2

A 62-year-old male patient made a routine visit to the provider’s office. The provider orders a written form of a lipid panel laboratory test and bills it with CPT code 80061.

This is to monitor and regulate lipid-lowering therapy. The patient was prescribed atorvastatin 10 mg three months ago.

In this circumstance, the provider orders the lipid panel laboratory test in written form to justify the medical necessity when submitting the claim.

A blood sample is taken from the left upper cubital vein to monitor the lipid level of the patient.

In this case, the venipuncture code (CPT 36415) is not separately reported as it is a part of the lipid panel test (CPT 80061).

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