36415

I am seeing a lot of denials for 36415? Was just wondering if I am missing something? I am new to coding and billing. I don't think I would need a modifier? Do insurances only pay for this code once per year? I read that somewhere, but I'm not sure if it is true or not? Please advise...

re: 36415

What do the denials say? And from which payers? Are you billing anything else with it (finger stick, etc.)?

re: 36415

Wellcare -- Non-covered charge

Humana -- Benefit included in another service/procedure that has been adjudicated

We do bill that code w/ other labs that we do in the office, but we also send some labs out to a laboratory...

re: 36415

We do not have problems with Humana, but we no longer bill (test) codes with the venipuncture. And, we do not have Wellcare here. The most direct route is probably to call each and get their reasoning.