Marilyn Posted Tue 17th of June, 2014 09:04:13 AM
When a patient comes in for coag therapy and Dr orders a DIG level, how would this visit be coded?
SuperCoder Answered Tue 17th of June, 2014 12:17:05 PM
Medicare does not reimburse for codes 99363 (Anticoagulant management for an outpatient taking warfarin, physician review and interpretation of International Normalized Ratio [INR] testing, patient instructions, dosage adjustment [as needed], and ordering of additional tests; initial 90 days of therapy [must include a minimum of 8 INR measurements]) which probably eliminates many of the patients to which the services would apply from your practice. Tracking patients for 90 days and verifying hospital or observation stays and the number of INRs keeps some family physicians from offering the care.
If you decide to report the services to a commercial plan that does cover them, they do not include the lab test (80162, Digoxin) or venipuncture (36415, Collection of venous blood by venipuncture). Any physician counseling regarding the patient's ongoing treatment, however, is covered by 99363 and 99364.
Hope this helps.