Beginning in 2003, cardiology practices are able to monitor mechanical heart valve patients on blood thinner Coumadin, or warfarin sodium, from home. (For coding instructions on in-office Coumadin monitoring, see the March 2003 Cardiology Coding Alert article "Keep Reimbursement Flowing With a Coumadin Coding Checkup.")
To ensure proper payment, you should report the following new G codes for at-home Coumadin monitoring, as appropriate, says Jim Collins, CHCC, CPC, president of Compliant MD Inc. in Matthews, N.C., and compliance manager for Mid Carolina Cardiology in Charlotte, N.C. Remember that, in general, only Medicare accepts G codes, so you should consult with private payers before billing these codes.
Bill G0248 when the patient has had training on self-testing. You can report this code only once in a patient's lifetime, Collins says.
Report G0249 for the materials and equipment the patient will use for in-home monitoring, Collins says. This code covers materials for four tests and cannot be billed more frequently than once every four weeks, he adds.
You should report G0250 when the physician reviews results and for any management the patient might need, Collins says. As with G0249, you cannot bill G0250 more frequently than once every four weeks.
Before billing these codes, check your local medical review policy for specific guidelines, Collins says.