Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Kathy -- Sorry, but I can't help. I don't do any venipuncture in my office. I use the hospital system labs (both large systems have labs within a 2 minute drive of my office). I'll assume there is someone on list who can help with this... if all else fails, I believe there was a similar discussion about this about 2 years ago, so perhaps it's in the archives. Good luck, Tim -- Malia, MD Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 (phone / fax) www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments. > This question is for those solo-solo docs or those who don't have > clinical staff. When you do a venipuncture in the office, do you code > it as a venipuncture or venipuncture by MD? How do you differentiate. > I usually code it as a regular venipuncture, 36415 as it doesn't require > my skill to do it, I'm just the only one there. I would reserve the > " venipunture by MD " if it requires my skill or access from an unusual > location (like foot). How do some of you code it? > > > > Kathy Saradarian, MD > > Branchville, NJ > > Solo low-staff practice since 4/03 > > In practice since 9/90 > > Practice Partner User since 5/03 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 I do it the same way you do Kathy. I only charge the “by MD” charge if somebody else tried before me and couldn’t get it. Annie Venipunctures This question is for those solo-solo docs or those who don’t have clinical staff. When you do a venipuncture in the office, do you code it as a venipuncture or venipuncture by MD? How do you differentiate. I usually code it as a regular venipuncture, 36415 as it doesn’t require my skill to do it, I’m just the only one there. I would reserve the “venipunture by MD” if it requires my skill or access from an unusual location (like foot). How do some of you code it? Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 I don’t do venipuncture, but I was not aware there even was a different code for “by MD”. What is the CPT code? I know this came up before & some were actually coding what they thought was venipuncture & it was really therapeutic phlebotomy (totally different). Venipunctures This question is for those solo-solo docs or those who don’t have clinical staff. When you do a venipuncture in the office, do you code it as a venipuncture or venipuncture by MD? How do you differentiate. I usually code it as a regular venipuncture, 36415 as it doesn’t require my skill to do it, I’m just the only one there. I would reserve the “venipunture by MD” if it requires my skill or access from an unusual location (like foot). How do some of you code it? Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 36410 for age 3 and up. I don’t do babies, so I don’t know the baby one. Annie Venipunctures This question is for those solo-solo docs or those who don’t have clinical staff. When you do a venipuncture in the office, do you code it as a venipuncture or venipuncture by MD? How do you differentiate. I usually code it as a regular venipuncture, 36415 as it doesn’t require my skill to do it, I’m just the only one there. I would reserve the “venipunture by MD” if it requires my skill or access from an unusual location (like foot). How do some of you code it? Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 There are many codes for venipuncture. There is 36415-Routine venipuncture, 36410-Venipuncture “requiring skill of MD, 36400-venipuncutre-femoral < 3 yo, 36405- venipuncture-scalp vein, < 3 yo, and 36406-venipuncture-other vein, < 3 yo. Then there are cut down’s and other things. Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Kathy, I usually use 36415 for routine venipuncture with 99000 for processing and handling of labs (centrifuging, storage, etc...) Soma --- Kathy Saradarian wrote: > There are many codes for venipuncture. There is > 36415-Routine venipuncture, > 36410-Venipuncture " requiring skill of MD, > 36400-venipuncutre-femoral < 3 > yo, 36405- venipuncture-scalp vein, < 3 yo, and > 36406-venipuncture-other > vein, < 3 yo. > > > > Then there are cut down's and other things. > > > > Kathy Saradarian, MD > > Branchville, NJ > > Solo low-staff practice since 4/03 > > In practice since 9/90 > > Practice Partner User since 5/03 > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Kathy, I do the same as Soma, 36415 and 99000. It seems most insurance companies pay for one or the other, but not both. I think if I had to do a venipuncture " requiring the skill of an MD " I wouldn't be able to do it! Don't forget we have access to Hughs from FP management to ask our billing questions. ,MD Trinity Medical Care, PC Virginia Beach, VA > > > There are many codes for venipuncture. There is > > 36415-Routine venipuncture, > > 36410-Venipuncture " requiring skill of MD, > > 36400-venipuncutre-femoral < 3 > > yo, 36405- venipuncture-scalp vein, < 3 yo, and > > 36406-venipuncture-other > > vein, < 3 yo. > > > > > > > > Then there are cut down's and other things. > > > > > > > > Kathy Saradarian, MD > > > > Branchville, NJ > > > > Solo low-staff practice since 4/03 > > > > In practice since 9/90 > > > > Practice Partner User since 5/03 > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 I did venipuncture for a while to help out my little old ladies and people who did not want to wait for an hour at the local LabCorp, coded only 36415 (did not know about 99000). Got paid $2-3 by our best payors!!! So stopped--NOT worth it. --Padma > > Kathy, > I do the same as Soma, 36415 and 99000. It seems most insurance > companies pay for one or the other, but not both. I think if I had > to do a venipuncture " requiring the skill of an MD " I wouldn't be > able to do it! > Don't forget we have access to Hughs from FP management to ask > our billing questions. > ,MD > Trinity Medical Care, PC > Virginia Beach, VA > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 100 patients a month x $3 x 12 months = $3,600 i would take that, send me your venipunctures! rocky --- Padma wrote: > I did venipuncture for a while to help out my little old ladies and > people who did not want to wait for an hour at the local LabCorp, > coded only 36415 (did not know about 99000). Got paid $2-3 by our > best payors!!! So stopped--NOT worth it. > > --Padma > > > > > > > Kathy, > > I do the same as Soma, 36415 and 99000. It seems most insurance > > companies pay for one or the other, but not both. I think if I had > > to do a venipuncture " requiring the skill of an MD " I wouldn't be > > able to do it! > > Don't forget we have access to Hughs from FP management to > ask > > our billing questions. > > ,MD > > Trinity Medical Care, PC > > Virginia Beach, VA > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Here is what AAFP Pract Mgt journal says...some are a few years old, so may not apply anymore Locke https://www.medicarenhic.com/whats_new/archive2005/deleteG0001_0105.htm G0001 (Routine Venipuncture) Procedure code G0001 has been deleted for 2005. CPT 36415 has been reactivated for Medicare billing. It is a clinical laboratory service, therefore it is paid under the clinical lab fee schedule and not the physician fee schedule. The claim requires a UPIN in item 17A for the ordering physician. https://www.noridianmedicare.com/p-medb/train/presentations/lab_billing.pdf Presentation on billing labs. http://www.empiremedicare.com/mr/venipuncture.htm Venipuncture Services: CPT Codes 36410/G0001* (* HCPCS code G0001 has been deleted and replaced by CPT code 36415 effective 1/1/2005) Why did we select this service for review? Procedure code G0001 (36415, effective 1/1/2005) is used to submit claims for a routine venipuncture for blood sampling. Procedure code 36410 is used to submit claims for a venipuncture requiring the clinical skill of a physician. Data analysis demonstrated an unusually high incidence of payment for services billed as 36410. Empire Medicare Services recognized this as potentially incorrect billing and chose to audit providers with unusual volumes of claims for this service. What did we find? Medical records revealed that venipunctures were not documented as other than routine, and did not require the skill of a physician. The vast majority of services reviewed were reduced to G0001 (effective 1/1/2005, CPT code 36415). Conclusion Empire reviewed claims for procedure code 36410 (Venipuncture necessitating a physician's skill) and found that this code was being used inappropriately in 100 percent of claims sampled. Empire recognized the need for clear direction on this service, and subsequently published a Local Coverage Determination (see below) that describes all clinical indications for using 36410 vs. 36415. What does this mean to you? As per Empire's Local Coverage Determination (NY_SU017G00/ NJ- L-66B), billing for 36410 is limited to medical conditions requiring venipuncture on veins of the neck, thorax, or groin, obviously requiring the skill of a trained physician. Drawing blood from an indwelling catheter or venous access device is not payable under this code. Use of a butterfly needle does not support the use of 36410, since it is not considered to be beyond the skill of a qualified and trained individual. Absence of venipuncture-trained office personnel may not be sole justification for the billing of 36410 by the physician. The 36410 code is properly billed only in those situations in which the physician's skill is integral to the blood drawing. The medical necessity of such instances must be documented in the patient's record. Use of 36410 requires careful documentation of the clinical situation that required a physician's skill for blood sampling. In the absence of such documentation, services will be denied upon review. http://www.aafp.org/fpm/20060900/fpmsuperbill.pdf Venipuncture 36415 http://www.aafp.org/fpm/991000fm/coding.html Routine venipuncture with office visit codes Q: What is the code for routine venipuncture, and can we code an office visit in addition to it? A: The code, which also covers finger- heel- or ear-stick, is 36415*. This is a " starred " procedure in CPT, which means that if the routine venipuncture is done at the time of an established patient visit and the routine venipuncture constitutes the major service at the visit (e.g., the patient is present simply to have his or her blood drawn), you should not code an office visit in addition to 36415. If routine venipuncture is performed at the time of a new patient visit and it constitutes the major service at the visit, then you should use the miscellaneous services code 99025 instead of an office visit code. Finally, you may code both an office visit and routine venipuncture at the time of any visit involving other significant, identifiable services (e.g., at the time of a comprehensive history and physical examination). http://www.aafp.org/fpm/20030700/coding.html Q Is venipuncture considered part of the lab test for which the specimen is drawn, or is it separately codable? A From a CPT perspective, collection of the specimen by venipuncture or finger/heel/ear stick is not considered an integral part of the laboratory procedure performed and, thus, may be coded separately. The CPT code for routine venipuncture is 36415, and the CPT code for finger/heel/ear stick is 36416. Note that Medicare uses G0001, not 36415, for routine venipuncture and does not allow separate payment of 36416. The laboratory CPT codes (80000-89399) should be used to report the performance of the lab test only. http://www.aafp.org/fpm/20050300/coding.html Venipuncture on a Medicare patient Q What code should I submit for venipuncture done on a Medicare patient? A You should use CPT code 36415, " Collection of venous blood by venipuncture. " Prior to this year, Medicare had its own HCPCS code, G0001, " Routine venipuncture for collection of specimen(s), " for this service. http://www.aafp.org/fpm/980900fm/coding.html Routine venipuncture Q:If a patient presents for a blood draw for lab work, can I code 36415* for the venipuncture and 99211? A:When a starred procedure such as 36415* is the major service provided at an established patient follow-up visit and that procedure is the main reason for the visit, an E/M service is usually not coded in addition to the procedure. If a lab test were then performed in your office lab, a code for the test could also be submitted. http://www.aafp.org/fpm/20000700/coding.html Lab specimen transportation Q: Can you explain the proper use of CPT code 99000? How does it relate to specimen collection, lab codes and venipuncture? A: CPT code 99000, " Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory, " is intended to be reported when the practice incurs costs to handle and/or transport a specimen to a lab. For example, if the practice employs a messenger service to transport a specimen, that service can be coded using 99000. In comparison, if lab staff pick up a specimen at no additional cost to the practice, it would not be appropriate to report code 99000. Code 99000 also is not intended for reporting the obtaining of a specimen. Reimbursement for obtaining a Pap smear or a throat culture is factored into the relevant lab procedure code. Obtaining a blood specimen by venipuncture may be reported separately, using code 36415, " Routine venipuncture or finger/heel/ear stick for collection of specimen(s). " http://www.aafp.org/fpm/20030100/14cptc.html There has also been a significant change in the coding of routine venipuncture. Code 36415 has been revised to read " Collection of venous blood by venipuncture. " Previously, this code also included finger, heel and ear sticks for blood specimen collection, but such capillary blood specimen collections should now be coded using the new code 36416. http://www.aafp.org/fpm/20040400/coding.html Note that the blood draw for the lab work should be coded separately using 36415, " Collection of venous blood by venipuncture " (assuming the blood was drawn using routine venipuncture) or G0001, " Routine venipuncture for collection of specimen(s) " (for Medicare beneficiaries). And if the blood draw was the only service received, 99211 would not be appropriate. 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Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Hi , I didn't know that we had a billing resource. Maybe I can stop torturing you all. How do we contact Hughs? Thanks so much. Moitridocboops wrote: Kathy,I do the same as Soma, 36415 and 99000. It seems most insurance companies pay for one or the other, but not both. I think if I had to do a venipuncture "requiring the skill of an MD" I wouldn't be able to do it!Don't forget we have access to Hughs from FP management to ask our billing questions. ,MDTrinity Medical Care, PCVirginia Beach, VA> > > There are many codes for venipuncture. There is> > 36415-Routine venipuncture,> > 36410-Venipuncture "requiring skill of MD,> > 36400-venipuncutre-femoral < 3> > yo, 36405- venipuncture-scalp vein, < 3 yo, and> > 36406-venipuncture-other> > vein, < 3 yo.> > > > > > > > Then there are cut down's and other things.> > > > > > > > Kathy Saradarian, MD> > > > Branchville, NJ> > > > Solo low-staff practice since 4/03> > > > In practice since 9/90> > > > Practice Partner User since 5/03> > > > > > > >>Moitri Chowdhury Savard, MD http://www.queenswesthealth.com The information contained in this message is confidential, may containprotected health information, may be legally privileged and is thusprotected from disclosure. It is intended solely for the use of theaddressee. If you are not the intended recipient, or an employee oragent responsible for delivering this message to the intendedrecipient, you are hereby notified that any disclosure, copying orsaving of this communication, or any action taken or omitted to betaken in reliance on it, is strictly prohibited and may be unlawful. Ifyou have received this communication in error, please notify usimmediately by replying to the message and deleting it from yourcomputer. Thank you. Finding fabulous fares is fun.Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Yes, but you are forgetting the following: cost of supplies, cost of the time spent (even if 3 – 5 minutes, is it worth it for $2 - $3?), hassle of transporting or sending samples out after collection. Re: Re: Venipunctures 100 patients a month x $3 x 12 months = $3,600 i would take that, send me your venipunctures! rocky --- Padma <padma8332> wrote: > I did venipuncture for a while to help out my little old ladies and > people who did not want to wait for an hour at the local LabCorp, > coded only 36415 (did not know about 99000). Got paid $2-3 by our > best payors!!! So stopped--NOT worth it. > > --Padma > > > > > > > Kathy, > > I do the same as Soma, 36415 and 99000. It seems most insurance > > companies pay for one or the other, but not both. I think if I had > > to do a venipuncture " requiring the skill of an MD " I wouldn't be > > able to do it! > > Don't forget we have access to Hughs from FP management to > ask > > our billing questions. > > ,MD > > Trinity Medical Care, PC > > Virginia Beach, VA > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 All supplies are provided by the lab, they come and pick up every day Just time of staff. rocky --- Brock DO wrote: > Yes, but you are forgetting the following: cost of supplies, cost of > the > time spent (even if 3 - 5 minutes, is it worth it for $2 - $3?), > hassle of > transporting or sending samples out after collection. > > > > > > > > Re: Re: Venipunctures > > > > 100 patients a month x $3 x 12 months = $3,600 > > i would take that, send me your venipunctures! > > rocky > > --- Padma <padma8332yahoo (DOT) <mailto:padma8332%40yahoo.com> com> > wrote: > > > I did venipuncture for a while to help out my little old ladies and > > > people who did not want to wait for an hour at the local LabCorp, > > coded only 36415 (did not know about 99000). Got paid $2-3 by our > > best payors!!! So stopped--NOT worth it. > > > > --Padma > > > > > > > > > > > > Kathy, > > > I do the same as Soma, 36415 and 99000. It seems most insurance > > > companies pay for one or the other, but not both. I think if I > had > > > to do a venipuncture " requiring the skill of an MD " I wouldn't be > > > > able to do it! > > > Don't forget we have access to Hughs from FP management to > > ask > > > our billing questions. > > > ,MD > > > Trinity Medical Care, PC > > > Virginia Beach, VA > > > > > > > > > Rakesh Patel MD > Arizona Sun Family Medicine, P.C. > 633 East Ray Road, #101 > Gilbert, Arizona 85296 > > www.azsunfm.com > > PLEASE NOTE: Email is not a secure form of communication. It should > not be > used for urgent or sensitive messages. Email may be done securely > through > our web portal. If you have a medical emergency go to an Emergency > Room or > call 911. > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Then if your staff is good at it (fast) & you truly do 100/month, then it is probably a good idea. For me, I would never draw that much blood & I can think of easier ways of making an extra $3/visit. Re: Re: Venipunctures > > > > 100 patients a month x $3 x 12 months = $3,600 > > i would take that, send me your venipunctures! > > rocky > > --- Padma <padma8332yahoo (DOT) <mailto:padma8332%40yahoo.com> com> > wrote: > > > I did venipuncture for a while to help out my little old ladies and > > > people who did not want to wait for an hour at the local LabCorp, > > coded only 36415 (did not know about 99000). Got paid $2-3 by our > > best payors!!! So stopped--NOT worth it. > > > > --Padma > > > > > > > > > > > > Kathy, > > > I do the same as Soma, 36415 and 99000. It seems most insurance > > > companies pay for one or the other, but not both. I think if I > had > > > to do a venipuncture " requiring the skill of an MD " I wouldn't be > > > > able to do it! > > > Don't forget we have access to Hughs from FP management to > > ask > > > our billing questions. > > > ,MD > > > Trinity Medical Care, PC > > > Virginia Beach, VA > > > > > > > > > Rakesh Patel MD > Arizona Sun Family Medicine, P.C. > 633 East Ray Road, #101 > Gilbert, Arizona 85296 > > www.azsunfm.com > > PLEASE NOTE: Email is not a secure form of communication. It should > not be > used for urgent or sensitive messages. Email may be done securely > through > our web portal. If you have a medical emergency go to an Emergency > Room or > call 911. > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 , Please share, what ways you can think of to make $3/visit. I have been really surprised by the outcomes of this discussion. I thought IMPs were all about the medical home and personal, superlative, extraordinary care of our patients and the majority of you say “I don’t do venipunctures, it’s not worth the time”. To clarify, I rarely do venipunctures for just that reason. Yes, Medicare pays $3 but no one else does. I just have a couple of patients I do it for because we used to do it at the old practice and they have just come to expect it and show up fasting and begging, or they have major transportation problems and can’t get to a lab. But I would have thought that doing venipunctures would be a primary service in the IMP practice. Still trying to get a feel for what separates IMP from the “old fashioned” or “traditional” practice. Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 I have no other clinical staff & I have not drawn blood (rarely if ever) myself. I prefer to emphasize waived labs like lipids, A1C, PT/INR, etc as well as OMT, cerumen removal, coding better, etc, etc rather than stress over $3 for a blood draw. Now, if I had an MA for other reasons, then sure I would have that person drawing blood. RE: Re: Venipunctures , Please share, what ways you can think of to make $3/visit. I have been really surprised by the outcomes of this discussion. I thought IMPs were all about the medical home and personal, superlative, extraordinary care of our patients and the majority of you say “I don’t do venipunctures, it’s not worth the time”. To clarify, I rarely do venipunctures for just that reason. Yes, Medicare pays $3 but no one else does. I just have a couple of patients I do it for because we used to do it at the old practice and they have just come to expect it and show up fasting and begging, or they have major transportation problems and can’t get to a lab. But I would have thought that doing venipunctures would be a primary service in the IMP practice. Still trying to get a feel for what separates IMP from the “old fashioned” or “traditional” practice. Kathy Saradarian, MD Branchville, NJ Solo low-staff practice since 4/03 In practice since 9/90 Practice Partner User since 5/03 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 That certainly would make sense. I am not in a solo-solo office (IMP) so for me it makes a lot of sense. rocky --- Brock DO wrote: > I have no other clinical staff & I have not drawn blood (rarely if > ever) > myself. I prefer to emphasize waived labs like lipids, A1C, PT/INR, > etc as > well as OMT, cerumen removal, coding better, etc, etc rather than > stress > over $3 for a blood draw. Now, if I had an MA for other reasons, > then sure > I would have that person drawing blood. > > > > > > > > RE: Re: Venipunctures > > > > , > > > > Please share, what ways you can think of to make $3/visit. > > > > I have been really surprised by the outcomes of this discussion. I > thought > IMPs were all about the medical home and personal, superlative, > extraordinary care of our patients and the majority of you say " I > don't do > venipunctures, it's not worth the time " . > > > > To clarify, I rarely do venipunctures for just that reason. Yes, > Medicare > pays $3 but no one else does. I just have a couple of patients I do > it for > because we used to do it at the old practice and they have just come > to > expect it and show up fasting and begging, or they have major > transportation > problems and can't get to a lab. But I would have thought that > doing > venipunctures would be a primary service in the IMP practice. Still > trying > to get a feel for what separates IMP from the " old fashioned " or > " traditional " practice. > > > > Kathy Saradarian, MD > > Branchville, NJ > > Solo low-staff practice since 4/03 > > In practice since 9/90 > > Practice Partner User since 5/03 > > > > > > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 Huges is the woman who writes the coding question section in the FP Management journal. She is an employee of the AAFP and as such is a free resousce for us. Just email her your questions at: chughes@... Re: reimbursement. I am certainly not making very much money at all drawing blood. Tricare doesn't pay at all Anthem pays only the 99000 at $4.75, not the 36415 Optima (a large local insurer here in VA) only pays the 36415, not the 99000 Go figure! It's a service to my patients. The majority we do send to outlying labs, but some we draw in the office. It's particularly helpful for the uninsured b/c then we can bill our business account for labs and pay a small fraction of what they would owe as " self-pay. " We collect the money up front as we have been provided a fee schedule by the three labs we participate with. I have a heart for the uninsured and want them to feel as if they can actually get healthcare in one of the richest countries in the world. > > > > > > Kathy, > > > I do the same as Soma, 36415 and 99000. It seems most insurance > > > companies pay for one or the other, but not both. I think if I had > > > to do a venipuncture " requiring the skill of an MD " I wouldn't be > > > able to do it! > > > Don't forget we have access to Hughs from FP management to > > ask > > > our billing questions. > > > ,MD > > > Trinity Medical Care, PC > > > Virginia Beach, VA > > > > > > > > > > Rakesh Patel MD > Arizona Sun Family Medicine, P.C. > 633 East Ray Road, #101 > Gilbert, Arizona 85296 > > www.azsunfm.com > > PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2007 Report Share Posted January 25, 2007 The problem with an IMP practice is that we COULD do virtually everything for the patient. For someone who is easily distracted this can be a real problem. We have been trained to do most simple procedures and some complicated ones. I know that I clocked many an early morning, drawing labs as a med student. I also worked as a phlebotomist, but I had to draw the line somewhere. I think that my patients can go to the local lab draw station, where there is an employee that is going to be there anyway drawing blood, is available all day, can do the registration, labeling, spin the blood etc. It is hard enough billing for office visit, but adding in labs would probably put me over the edge. We have to decide what is most beneficial for our patients as well as how we can make a living. If we go under because we spend so much time on many many little extras, that isn't much service to our patients. When I am the only medical person in the office, I am hard pressed just getting my office stuff, medical note, referrals, xrays ordered etc. If I did labs to, I would never get home. If I had an MA, that had some time on his or her hands, then it might be worthwhile. Remember that the patients are saving a lot of time, but not having to wait in a waiting room for 45 minutes to an hour. Getting labs done elsewhere, isn't such a hardship. More power to those that draw labs, but I am happy that I chose not to do so. What I usually do regarding regular labs for hpt, diabetes and cholesterol, is to have the patient get them done 1-2 days before seeing me, then I can review the labs with them. These labs often need to be done fasting anyway. I send the order with the patient for their next visit. They seem to keep track of it better than the lab when I was sending the orders to the lab. Our hospital lab also has some wellness testing labs that patients can pay cash for that are much cheaper than what is billed to the insurance. Kathy Broman MD Mason City, IA One part time office manager, who answers the phone and makes appointments, when not on the phone trying to get the insurance companies to pay or explain why they didn't pay. On Wednesday, January 24, 2007, at 10:01 AM, Rocky Patel wrote: > That certainly would make sense. I am not in a solo-solo office (IMP) > so for me it makes a lot of sense. > > rocky > > --- Brock DO wrote: > > > I have no other clinical staff & I have not drawn blood (rarely if > > ever) > > myself. I prefer to emphasize waived labs like lipids, A1C, PT/INR, > > etc as > > well as OMT, cerumen removal, coding better, etc, etc rather than > > stress > > over $3 for a blood draw. Now, if I had an MA for other reasons, > > then sure > > I would have that person drawing blood. > > > > > > > > > > > > > > > > RE: Re: Venipunctures > > > > > > > > , > > > > > > > > Please share, what ways you can think of to make $3/visit. > > > > > > > > I have been really surprised by the outcomes of this discussion. I > > thought > > IMPs were all about the medical home and personal, superlative, > > extraordinary care of our patients and the majority of you say " I > > don't do > > venipunctures, it's not worth the time " . > > > > > > > > To clarify, I rarely do venipunctures for just that reason. Yes, > > Medicare > > pays $3 but no one else does. I just have a couple of patients I do > > it for > > because we used to do it at the old practice and they have just come > > to > > expect it and show up fasting and begging, or they have major > > transportation > > problems and can't get to a lab. But I would have thought that > > doing > > venipunctures would be a primary service in the IMP practice. Still > > trying > > to get a feel for what separates IMP from the " old fashioned " or > > " traditional " practice. > > > > > > > > Kathy Saradarian, MD > > > > Branchville, NJ > > > > Solo low-staff practice since 4/03 > > > > In practice since 9/90 > > > > Practice Partner User since 5/03 > > > > > > > > > > > > > > Rakesh Patel MD > Arizona Sun Family Medicine, P.C. > 633 East Ray Road, #101 > Gilbert, Arizona 85296 > > www.azsunfm.com > > PLEASE NOTE: Email is not a secure form of communication. It should > not be used for urgent or sensitive messages. Email may be done > securely through our web portal. If you have a medical emergency go to > an Emergency Room or call 911. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2007 Report Share Posted January 25, 2007 I agree we all need to draw the line somewhere, but we can also be creative with some of this stuff, too. Some docs have said it takes too much time to do the vitals, too -- so they hire a med tech. Other docs say they use the taking of the vital signs as a time to chat with the patient about why they are presenting or about the recent high school basketball game. It gives them more "hands on" time with the patient. I probably won't be drawing blood in my future IMP office because there is a hospital lab draw station 30 feet away from my office. Anyway, there might be creative ways to incorporate the blood draw in the flow of things. If it takes 3-minutes to draw the blood, one could chat about the importance of exercise or diet when drawing their lipids -- or somesuch. Just a thought. Locke, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2007 Report Share Posted January 25, 2007 Quest is easier to deal with than local hospital blood draw for me, but I can access hosp database. All is local Dr Matt Levin FP solo since Dec2004 Residency finished 1988 RE: Re: Venipunctures I agree withn Kathy. I also think it depends on thespecific patient population you cater. I have asolo-solo-solo practice that's six months old inManhattan. I start seeing patients at 7:30 AM. Theyare hard working and find it difficult to wait atQuest Diagnostics for a half-hour to hour to get theirblood drawn. Plus, have you ever dealt with people atQuest or Labcorp? I have. I've gone in as a"layperson" and they make the simplest things into themost difficult situation. This is what many of mypatients have expressed to me as well.I get reimbursed anywhere from $5-10 for phlebotomy.One insurance carrier even paid me $40, but for somereason I think it was a fluke. We'll see what happenswith the same payer during the next billing cycle. I don't find phlebotomy time consuming, it usuallygoes pretty fast, the only real problem I had once iswhen a patient vaso-vagaled on me, but that was aboutit. I have the forms ready for most patients(insurance info, patient info, etc) and most of thebasic stuff is already checked off. If I need to addanything on to the list, I do so. I pop the tubes intothe centrifuge and spin away. My only anxiety is thatthe tubes are not balanced and that things will goflying everywhere. My patients stick with me because they can get theirneeds taken care of in one place. It's probably partof the Manhattanite-culture, but something that I'vehad to adapt to and accept. I think the other part of this whole equation for meis that I trained at NYU/Bellevue Hospital where Ialways had to do my own ECGs, labs, patient transport,etc. Life in comparison now is a breeze. Soma--- Kathy Saradarian <qualityfphughes (DOT) net> wrote:> ,> > > > Please share, what ways you can think of to make> $3/visit. > > > > I have been really surprised by the outcomes of this> discussion. I thought> IMPs were all about the medical home and personal,> superlative,> extraordinary care of our patients and the majority> of you say "I don't do> venipunctures, it's not worth the time". > > > > To clarify, I rarely do venipunctures for just that> reason. Yes, Medicare> pays $3 but no one else does. I just have a couple> of patients I do it for> because we used to do it at the old practice and> they have just come to> expect it and show up fasting and begging, or they> have major transportation> problems and can't get to a lab. But I would have> thought that doing> venipunctures would be a primary service in the IMP> practice. Still trying> to get a feel for what separates IMP from the "old> fashioned" or> "traditional" practice. > > > > Kathy Saradarian, MD> > Branchville, NJ> > Solo low-staff practice since 4/03> > In practice since 9/90> > Practice Partner User since 5/03> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 I get paid around $20 for venipunctures and my patients love the convenience. Totally worth it. Maggie Carpenter, MD Brooklyn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 What CPT code are you using? $20 for venipuncture? Hard to believe. Re: Venipunctures I get paid around $20 for venipunctures and my patients love the convenience. Totally worth it. Maggie Carpenter, MD Brooklyn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 Who is paying you $20 and what cpt code are you using? rocky --- Maggie Carpenter wrote: > I get paid around $20 for venipunctures and my patients love the > convenience. Totally worth it. > Maggie Carpenter, MD > Brooklyn > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2007 Report Share Posted January 29, 2007 Yes, that was my same question. I have a feeling this is the same discussion that took place on the list last year: the $20 vs $3 for everyone else is likely because she is erroneously submitting the “therapeutic phlebotomy” code instead of “venipuncture.” Could just be higher because of her location, but I doubt it would be that much higher. Re: Re: Venipunctures Who is paying you $20 and what cpt code are you using? rocky --- Maggie Carpenter <julesandzoemom> wrote: > I get paid around $20 for venipunctures and my patients love the > convenience. Totally worth it. > Maggie Carpenter, MD > Brooklyn > Rakesh Patel MD Arizona Sun Family Medicine, P.C. 633 East Ray Road, #101 Gilbert, Arizona 85296 www.azsunfm.com PLEASE NOTE: Email is not a secure form of communication. It should not be used for urgent or sensitive messages. Email may be done securely through our web portal. If you have a medical emergency go to an Emergency Room or call 911. Quote Link to comment Share on other sites More sharing options...
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