2025 CPT code 36406
Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Feed
Venipuncture performed on a child under 3 years of age (excluding femoral, jugular, or scalp veins), requiring the specialized skill of a physician or other qualified healthcare professional; this code is not for routine blood draws.
Modifiers may be applicable to further specify the circumstances of the procedure. Refer to current CPT coding guidelines for appropriate modifier usage.
Medical necessity for this code must be supported by documentation explaining why the skill of a physician or other qualified healthcare professional was required for the venipuncture, given the patient's age and the difficulty in accessing suitable veins. Routine venipuncture would not meet medical necessity criteria.
The physician or qualified healthcare professional is responsible for assessing the patient's condition, selecting the appropriate vein, performing the venipuncture using aseptic technique, ensuring patient comfort, and addressing any complications that may arise.
In simple words: This procedure involves a doctor or other trained medical professional drawing blood from a vein in a child under 3 years old, specifically from veins other than those in the neck, head, or groin. This is done when regular nurses or technicians can't easily access the vein due to its small size.
Venipuncture performed on a patient younger than 3 years of age, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein (excluding femoral, jugular, or scalp veins).
Example 1: A 2-year-old child requires a blood sample for diagnostic testing, but their veins are difficult to access, necessitating the expertise of a physician., An 18-month-old infant needs intravenous (IV) access for medication administration, but their peripheral veins are too small or fragile for standard venipuncture by a nurse, requiring a skilled physician to establish the IV line., A critically ill 2-year-old requires frequent blood draws for laboratory monitoring, and the complexity of the case requires the skill of a physician for safe and efficient venous access.
The medical record should clearly document the medical necessity for a physician or other qualified healthcare professional to perform the venipuncture. This could include the child's age, the difficulty in locating suitable veins, the urgency of the situation, or the complexity of the patient's condition. The specific vein accessed should also be documented.
** Code 36406 should be used only when the specific skills of a physician or other qualified healthcare professional are required due to the patient being under 3 years of age, and when veins other than the femoral, jugular, or scalp veins are used. For routine venipuncture in patients of any age, use code 36415. For other types of difficult venipunctures, see codes 36400, 36405, 36410, and 36420-36425.
- Specialties:Pediatrics, Emergency Medicine, Hospitalists, Anesthesiology, Critical Care, Neonatology.
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Home, Skilled Nursing Facility, Nursing Facility.