tci Medicare Compliance & Reimbursement - 2023 Issue Q3

Reader Questions: Get a Grip on Fingerstick Reimbursement

Question: Our lab collects capillary blood by fingerstick for certain tests rather than venipuncture. Can we expect payment for this service? AAPC Forum Participant Answer: You probably can’t expect reimbursement for fingerstick blood collection, even though CPT® provides a code for the service — 36416 (Collection of capillary blood specimen (eg, finger, heel, ear stick)). Most payers, including Medicare, assume the exam or test procedure includes the cost of most simple specimen collection procedures, such as fingerstick, urine cup collection, or culture swab. Many payers do cover the cost of a routine venipuncture blood draw — 36415 (Collection...

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