Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.2

Coding Requirements for Specimen Collection

Last amended: 2023Year: 2023Length: 137 wordsOfficial source
60.1.2 - Coding Requirements for Specimen Collection (Rev. 11778, Issued:01-06-23; Effective:01-01-23, Implementation:01-23-23) The following HCPCS codes and terminology must be used: • 36415 - Collection of venous blood by venipuncture. • G0471 - Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (SNF) or by a laboratory on behalf of a home health agency (HHA) • P9612 - Catheterization for collection of specimen(s), (single patient), all places of services • P96l5 - Catheterization for collection of specimen(s), (multiple patients) The allowed amount for specimen collection in each of the above circumstances is included in the laboratory fee schedule distributed annually by CMS via a Recurring Update Notification (RUN) change request. Neither the annual deductible nor the 20 percent coinsurance for Medicare apply to the specimen collection fees.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 16 § 60.1.2: Coding Requirements for Specimen Collection | Justis AI