Venipuncture: Not Covered by This Payer (Facility Setting)
Published 02/08/2018
Procedure Code:
- CPT code 36415
Denial Reason, Reason/Remark Code(s)
- CO-109: Claim is not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
Resolution/Resources
- Venipuncture is not covered under Part B in a facility setting. These charges are part of the hospital's bill to Medicare (Part A). Facility settings include the following places of service:
- 19: off campus outpatient hospital
- 21: inpatient hospital
- 22: on campus outpatient hospital
- 23: emergency room- hospital
- 51: inpatient psychiatric facility
- 52: psychiatric facility partial hospitalization
- 61: comprehensive inpatient rehabilitation facility
- 62: comprehensive outpatient rehabilitation facility
- Do not submit Part B claims for venipuncture performed in these settings to Palmetto GBA