Forum - Questions & Answers
36415 global?
I have a local carrier that denies CPT 36415 as global to the office visit. Has anyone heard of this before or had any similar situation? Sometimes I have patients come in just for lab draws without seeing a provider.
36415 global
I do know that Aetna routinely bundles the venipunctures into the E&M codes, but I have not seen any other carriers do it
36415 Global Response
I have a carrier that has denied CPT 36415 as global as well, and I filed an appeal for payment. The funny thing about it is that this specific carrier has been paying for the CPT 36415 since the patient has been coming to the clinic. This just happened recently (within the last two weeks) and I don't know what we are going to do for this.
You have three choices
1- If you are billing for the labs and making money, consider the write-off as the cost of doing business.
2- Complain to the insurer, if you can actually get a human on the phone that cares at all about you.
3- If the lab is billing for the tests, then you have nothing to gain by drawing the blood besides decreasing our productivity. So for those patients, hand them a list of the draw sites for the lab and a prescription to have the labs done and a letter telling them that their insurer no longer pays for them to have their blood drawn at the office and give a number to call at the insurance company to complain.