Venipuncture coding may seem like an intimidating task, but it’s actually fairly straightforward once you understand the basics. To that effect, AAPC has put together a handy list of important information to keep in mind when coding these common procedures.

First, consider the code itself. According to the CPT manual, the proper designation for venipuncture coding is 36415 (Collection of venous blood by venipuncture). This code is not number specific, so use this 36415 regardless of the total instances of venipunctures. According to the “Respiratory, Cardiovascular, Hemic, & Lymphatic Systems” chapter of National Correct Coding Initiative (NCCI) Policy Manual, “CPT code 36415 describes collection of venous blood by venipuncture. Each unit of service (UOS) of this code includes all collections of venous blood by venipuncture during a single episode of care regardless of the number of times venipuncture is performed to collect venous blood specimens. Two or more collections of venous blood by venipuncture during the same episode of care are not reportable as additional UOS.”

In addition, 36415 should never be reported in conjunction with Modifier 63. This modifier specifies that the procedure in question was performed on an infant who weighed less than 4 kg, which is not a proper use for venipuncture. It is also important to note that many insurance carriers, including Medicare, do not provide reimbursement for routine venipuncture.

Though they are not as common, there are also a handful of codes used to report venipuncture requiring a physician. These codes are as follows:

  • 36400: Venipuncture, younger than age 3 years, necessitating physician skill, not to be used for routine venipuncture; femoral or jugular vein
  • 36405: …scalp vein
  • 36406: …other vein
  • 36410: Venipuncture, age 3 years or older, necessitating physician skill (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)

Unlike 36415, Medicare will usually reimburse these instances of venipuncture coding as long as they are properly supported by the documentation.