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Phlebotomy & Blood Billing

Phlebotomy Billing

Did you know rather than coding routine blood draws as 99195, practices should use either 36415 (routine venipuncture or finger/heel/ear stick for collection of specimen[s]) bundled within an evaluation and management (E/M) code, 99211-99215, or a laboratory test code, such as 85022 (hemogram, automated, and manual differential WBC count [CBC])?  This will ensure their coding practice for blood draws complies with Medicare regulations.

Did you also know that if you collect specimen for testing at outside lab, although testing is done by an outside laboratory, practices can still bill for the blood draw?  Local medical review policies also say that separate charges made by physicians, independent, or hospital laboratories for drawing or collecting specimens should be allowed whether or not the specimens are referred to doctors or other laboratories.

CBS can assist you and your staff in becoming more aware of the different avenues to bill for your in-office Blood Draws keeping you informed of all updates and CMS requirements as they are posted and place into affect.

 

Blood Billing

Recently Medicare Hospital Outpatient Prospective Payment System posted updates about the payment rates for blood products and transfusion and cellular therapy services.  The rule issued in early November by the Centers for Medicare and Medicaid Services, calls for decreases in payments for several frequently transfused blood products and increased payments for transfusion and stem cell related services.  Providers are urged to bill using the appropriate blood-related and stem cell processing codes so that CMS can obtain better cost data to help determine payments for these products and services in the future.  The new payment system took effect Jan. 1, 2013.

A proposed rule issued by the Centers for Medicare and Medicaid Services, calls for relatively small decreases in payments for certain widely transfused blood products (e.g., the payment for leukoreduced RBCs would fall from $198.90 in 2012 to $193.19 in 2013).  Proposed payments for most bone marrow and stem cell procedures would increase but in general still lag below the actual costs of these services.

As precious and unique blood products are, so should be the way that it is billed.  Taking precious time in accurately capturing all revenue for your group is crucial in its future success.  CBS processes this detailed and unique billing carefully, identifying crucial diagnosis and supporting documentation to make sure every drop is paid for.