Laboratory Question for the Week of March 26, 2018

Laboratory Compliance Question of the Week

Question:

Why does the 2018 NCCI Policy Manual state that we can only charge for one venipuncture (36415) per patient encounter, but the MUE limit for 36415 is set at 2 per date-of-service?

Answer:

The medically unlikely edit (MUE) is set so in the event a patient is seen two different times for outpatient encounters the provider can report each specimen collection. For example, in the morning, labs are drawn for chronic conditions, and separate labs are drawn later in the same day for an emergency department visit. The MUE is set to allow for billing of venipunctures at separate or distinct encounters.

 

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.