Specimen collection can be an important part of performing respiratory therapy services. Which codes represent specimen collection services? There are several distinct codes for reporting these services. These include 36415, 36591, 36592, 36600, and 89220. Let’s review the fundamentals of each service to build success this year and beyond.
The first worth noting is Venipuncture. You can report the level I code 36415 to all payers including Medicare. Note that Medicare will reimburse for the venipuncture procedure once per encounter. One important factor to be aware of is to be sure to differentiate between venipuncture, capillary collection and draws from a line or access device. When collecting capillary specimens (36416), the related cost is considered by Medicare to be insignificant and should be bundled to the test procedure. For 2022, 36416 has again been assigned to status indicator “N,” meaning it is always packaged, and 36415 has been assigned to status indicator “Q4,” which means it will be conditionally packaged if billed on the same claim as a HCPCS code assigned a published status indicator “J1,” “J2,” “S,” “T,” “V,” “Q1,” “Q2,” or “Q3.” Understand that in other circumstances, payment will be made under the Clinical Laboratory Fee Schedule (CLFS). Do recognize that blood specimen collection performed during an IV start is not separately billable.
• For Venous Access Device (VAD), understand that code 36591 (collection of a blood specimen from a completely implantable VAD) can only be utilized when the VAD blood draw is from a completely implanted device, such as a Porta-Cath or Mediport. CPT® 36591 is designated as having a status indicator of “Q1.” A “Q1” is an “STV-packaged procedure.” Note that a procedure that has this designation may be separately reported to Medicare, but separate payment will be received only if no other status indicator “S,” “T,” or “V,” APC reimbursed procedure is billed on the same claim.
Know that CPT code 36592 should be assigned for blood draw from a PICC line or Hickman catheter. For 2022, code 36592 has been assigned to the same APC and status indicator as 36591. As stated above, the payment strategy referred to as “STV-packaged” codes means that conditions exist under which separate payment will be made, but when those conditions are not met, the payment will be packaged.
The codes assigned to a “Q1” status indicator will be paid separately when appearing on a claim without an “S,” “T,” or “V” procedure. Great concern exists by hospitals that question whether CPT codes 36591 and 36592 would ever be paid as their use is for the collection of blood specimens for laboratory testing. The AMA provided clarity by including a parenthetical note following each of these codes limiting their use with other laboratory services only.
When billing for arterial puncture specimen collection, report 36600. This CPT code holds a status indicator of “Q1” under the OPPS payment guidelines, meaning that, like the venous access device codes above, it will be paid separately when appearing on a claim without an “S,” “T,” or “V” procedure or separately through APC 5734. Note that this code is for the actual puncture of the artery; line draws are part of the continuum of care and not separately billable. The revenue center for blood specimen collection procedures should be 0300 unless instructed otherwise by the Part A/B MAC.
What about when it comes to sputum for diagnostic testing? Code 89220 is a covered service. The revenue code should be 0300, 0309, 0410, or 0419.
With the increase in “rapid screening tests” for respiratory syncytial virus (RSV) and influenza, MedLearn consultants have been receiving requests to provide CPT and billing instruction for collection of specimens via nasal lavage and suction. Unfortunately, there is no CPT or HCPCS code that represents the collection of this specimen. The cost is bundled into the cost of CPT codes 87631–87633.
Explore more billing tips and insight for respiratory CPT coding by ordering our Coding Essentials for RT/Pulmonary Function resource.
Let me start with some follow-up on a topic I have written about before: the widening of the use of “against medical advice” (AMA) to
The 30th Annual Compliance Institute for the Health Care Compliance Association (HCCA) is scheduled to take place in Orlando next week. If you are there,
Please log in to your account to comment on this article.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
