Forum - Questions & Answers

Apr 20th, 2016 - bgray

Billing Issues with 36415 and G0471

I do billing for an Independent Lab that has staff that goes to Skilled Nursing Facilities and Nursing Homes they draw the blood and bring it back to the lab for the tests to be preformed. We mainly work with Medicare Plans. However, we do have some commercial plans and they have been denying CPT® code 36415 or G0471 as not separately reimbursed when submitted with 80050 (just one example) keep in mind, we sometimes bill for several CPT® codes, it is not just one insurance carrier it is several. Is there anything I can do to get this covered? Medicare allows and pays for this procedure and all the Medicare Plans do. I am at a loss on what we can do so we do not have to write this off.

Jul 13th, 2016 - tperrin 1 

re: Billing Issues with 36415 and G0471

I noticed the same thing on 36415. From my research it appears that most commercial plans do not cover it separately

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