aetna Venipuncture Billed with Certain Lab Codes

Effective October 16, 2021

As a result of a recent review, and consistent with industry standards for venipuncture reimbursement, Aetna will deny CPT code 36415 when billed with certain lab codes as incidental. The method of obtaining the sample is integral to performing the laboratory analysis when reported by the same provider.

This update excludes claims billed with modifier 59 and national lab Taxpayer Identification Numbers.

Source: https://editiondigital.net/publication/?m=33093&i=714613&p=6&ver=html5