A doctor needs to be present to draw blood?

Nurses Safety

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I go to my doctor's office for routine blood draws--it's drawn by the LPN. One day recently I went there to have blood drawn. After a few minutes wait, the LPN said to me "sorry for the wait--I'm just waiting for Dr. Jones to show up. I can't draw it until there is a doctor in the building."

Is this the usual policy at doctors' offices? Were they afraid that she might nick my aorta while drawing blood from my AC (and, yes, I say this in jest)? Is there a doctor present at every lab site that draws blood?

This has nothing to do with patient safety and everything to do with billing. The blood draw can't be billed if the Dr. they are billing the service under is not in the office. It's a Medicare rule that most insurance companies follow. MA's and Aides can draw blood in any state that puts those services within their scope of practice. But you still can't bill for it if the Dr. isn't in the office. NP's and PA's can also supervise and bill, but they also need to fulfill that presence requirement. I work in compliance, we see this question all the time.

Specializes in PICU.
This has nothing to do with patient safety and everything to do with billing. The blood draw can't be billed if the Dr. they are billing the service under is not in the office. It's a Medicare rule that most insurance companies follow. MA's and Aides can draw blood in any state that puts those services within their scope of practice. But you still can't bill for it if the Dr. isn't in the office. NP's and PA's can also supervise and bill, but they also need to fulfill that presence requirement. I work in compliance, we see this question all the time.

I can see this... The MD in essence has to "order" the lab draw. The bold part was what I thought was interesting and very well could explain it

Specializes in PICU, Sedation/Radiology, PACU.

Although the original post is nearly 3 years old, billing could have been a reason for this policy. It also may have been a policy in case a patient has some sort of vaso-vagal reaction requiring medical assistance.

Specializes in Critical Care.

There's no general reimbursement requirement that says an MD has to be physically present in the building in order to bill for phlebotomy. Some blood draw clinics are located in the same complex as a hospital facility or physician's clinic, some are not, it has no effect on reimbursement either way. It's also not unusual for phlebotomists to go out into the community to do draws, ours do daily trips to nursing homes for draws, it's covered the same either way.

I agree that there must have been an incident or a new policy in place for the LPN to have an MD on site; however, there must be an MD on site for MA's to draw labs. The ONLY thing MA's can do without DIRECT SUPERVISION (MD on site) is collect urine, sputum and BP check. Unfortunately, more offices than we realize do not follow the law.

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