Medicaid NC Will Not Pay for CPT Code 36415 (Venipucture)!

NC Medicaid has published an update in the October 2012 Bulletin.  CPT Code 36415 will not be covered if the provider is performing the test in his/her facility. Medicaid will cover 36415 when blood is collected and sent to a non-related outside facility without performing any tests.

Read the bulletin below and click on the link to go directly to the Medicaid NC website.

http://www.ncdhhs.gov/dma/bulletin/1012bulletin.htm#cpt

Billing Reminder for CPT Code 36415

Collection of Specimens

CPT procedure code 36415 (collection of venous blood by venipuncture) was added as a covered service during the 2005 CPT code update. CPT code 36415 replaced G0001 as of January 1, 2005. Providers must use 36415 when billing this service to N.C. Medicaid.
N.C. Medicaid will not reimburse for the collection of venous blood when providers performs testing in their facilities. Medicaid will only reimburse for the collection of venous blood when a provider draws the blood and sends it to a non-related outside facility without performing any testing. One collection fee is covered per beneficiary regardless of the number of specimens drawn.