CPT Code 36415 (2021)

According to the CPT manual, the correct code for venous puncture encoding is CPT 36415 (venous blood collection by venous puncture). This code is not intended for specific purposes, but for the total number of venous punctures. For a significant number of doctors who take blood in their practice to perform a laboratory test, the CPT code 36415 is billed as the test code according to the Centers for Medicare – Medicaid Services (CMS).

Description CPT Code 36415

“A needle is inserted into the skin over a vein to puncture the blood vessel and withdraw blood for venous collection in 36415. In 36416, a prick is made into the finger, heel, or ear and capillary blood that pools at the puncture site is collected in a pipette. In either case, the blood is used for diagnostic study and no catheter is placed.”

The current procedure terminology for CPT Code 36415 does not require a medical qualification. The refusal of a claim for payment of CO-97, M15, M144 or N70 must be adjusted if the procedure or service is not paid.

The American Medical Association created Modifier 33 to allow providers to identify preventive services for patients without cost sharing that do not apply to patients protected by the Affordable Care Act. This modifier is suitable for diagnostic and treatment services as well as for carrying out preventive services. In some cases, the appropriate diagnostic code depends on the type of depression the patient has.

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