Collection of venous blood by venipuncture
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Bundled with other procedures - venipuncture included in panel
Very Common36415 (venipuncture for collection) is bundled with most lab panels and cannot be billed separately. CMS and most commercial payers consider venipuncture integral to specimen collection.
Common Causes
- • Billed with lab panel codes (80047-80076, 80081, etc.)
- • Medicare policy bundles venipuncture into all labs
- • Commercial payers follow NCCI edits bundling 36415
Resolution Strategy
Venipuncture bundled per payer policy and cannot be unbundled. Charge should be removed. Only billable in very limited circumstances (blood donation, some point-of-care tests).
💬 Plain Language Explanation
What this means
This is a routine blood draw. A healthcare provider collected a blood sample from you, typically from your arm.
Why you might see this
This is a very common code on medical bills. You'll see it whenever blood is drawn for lab tests. Sometimes this is billed separately, and sometimes it's included in the office visit charge.
Common context
Very common code - appears on most bills with lab work. Sometimes bundled with office visits.
What to ask your provider
"'Was this blood draw billed separately, or was it included in my office visit? Some insurance plans bundle this into the visit charge.'"
Relative Value Units (RVUs)
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Clinical Information
When to Use
For routine venipuncture for blood collection
Common Scenarios
Documentation Requirements
- Location of venipuncture site
- Number of attempts
- Amount of blood drawn
- Type of tubes collected
- Any complications
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes venipuncture
- Includes blood collection
- Laboratory testing coded separately
- Multiple venipunctures coded separately
- Arterial puncture coded separately
Exclusions
- 36416 (collection of capillary blood)
- 36600 (arterial puncture)
- 36410 (routine venipuncture for collection of specimen)
Coding Notes
Clinical scenarios
- Location of venipuncture site
- Number of attempts
- Amount of blood drawn
- Location of venipuncture site
- Number of attempts
- Amount of blood drawn
- Location of venipuncture site
- Number of attempts
- Amount of blood drawn
Who are you?
Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
National Limit: $9.09
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Ask a QuestionFrequently Asked Questions
CPT 36415 is the billing code for "Collection of venous blood by venipuncture". For routine venipuncture for blood collection
CPT 36415 has a total RVU of 0.88, broken down as: Work RVU 0.35, Practice Expense RVU 0.50, and Malpractice RVU 0.03. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 36415 is "Bundled with other procedures - venipuncture included in panel". 36415 (venipuncture for collection) is bundled with most lab panels and cannot be billed separately. CMS and most commercial payers consider venipuncture integral to specimen collection. Common causes include: Billed with lab panel codes (80047-80076, 80081, etc.); Medicare policy bundles venipuncture into all labs. Appeal success rate is approximately 10-30%.
Key documentation requirements for CPT 36415 include: Location of venipuncture site; Number of attempts; Amount of blood drawn; Type of tubes collected. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 36415: Includes venipuncture. Includes blood collection Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 36415 include: 59 (Distinct procedural service if performed separately), LT (Left side procedure), RT (Right side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 36415 is 2-5 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.