What is CPT code G0471?

HCPCS code G0471 for Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (SNF) or by a laboratory on behalf of a home health agency (HHA) as maintained by CMS falls under Other Services .

What is procedure code P9604?

P9604 – Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge.

Does Medicare pay P9604?

Medicare bases the payment for these services on the clinical laboratory fee schedule. The travel codes allow for payment either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604). Medicare makes payment of the travel allowance only if a specimen collection fee is also payable.

What is CPT P9603?

Per Mile Travel Allowance (HCPCS P9603) The per mile travel allowance is to be: Used in situations where the average trip to the patients’ homes is longer than 20 miles round trip, and. Prorated in situations where specimens are drawn from non-Medicare patients in the same trip.

Is there an age limit on 90471?

Code 90471 is used when the drug is administrated by a medical assistant or nurse and the patient does not see the physician at all. This code would also be used for any patient 19 years of age or older regardless if physician is present and does face-to-face counseling.

How Much Does Medicare pay per mile?

CMS computes the allowance per mile by using the Federal mileage rate of $0.56 per mile plus an additional $0.45 per mile to cover the technician’s time and travel costs. MACs have the option of establishing a higher per mile rate in excess of the minimum $1.01 per mile, if local conditions warrant it.

Does Medicare pay for venipuncture?

If a venipuncture performed in the office setting requires the skill of a physician for diagnostic or therapeutic purposes, the performing physician can bill Medicare both for the collection – using CPT code 36410 – and for the lab work performed in-office.

Does Medicare cover P9603?

Medicare pays for these services based on the Clinical Laboratory Fee Schedule (CLFS). The travel codes allow for payment either on a per mileage basis (P9603) or on a flat rate per trip basis (P9604). Payment of the travel allowance is made only if a specimen collection fee is also payable.

What is a 90471?

Is specimen collection HCPCS code g0471 reimbursable?

Consistent with CMS, specimen collection HCPCS code G0471 is reimbursable only when a Specimen is collected from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency.

What is the CPT code for venipuncture?

Venous blood collection by venipuncture and capillary blood specimen collection (CPT codes 36415 and 36416) will be reimbursed once per patient per date of service when reported by the Same Individual Physician or Other Qualified Health Care Professional.

What is the CPT code for capillary blood collection?

Healthcare Common Procedure Coding System (HCPCS Level II) code S9529 and capillary blood collection code 36416, are eligible for separate reimbursement when reported with an E/M and/or a laboratory service.

What is the most common venipuncture method?

The most common method and site of venipuncture is the insertion of a needle into the cubital vein of the anterior forearm at the elbow fold. Please refer to the coding section of this policy for the CPT code most applicable to the method of blood withdrawal.