Cardiology Coding Alert

Question: We normally report 36415 when patients present for Coumadin treatment, but our cardiologist also calls the patients to discuss the results and to manage treatment. Can we report any other codes to reflect the detailed nature and time that we spend on this phone call?

California Subscriber

Answer: You cannot bill an E/M service when you merely perform a test or convey test findings. CPT does include codes for telephone calls (99441-99443), but-most payers don't cover them.

Cardiology practices should report E/M codes (99201-99215) if they administer Coumadin testing in-house and perform a substantial, separate E/M service in-addition to the routine Coumadin clinic visit.

When the cardiologist calls the patient to convey test findings, you should consider his phone call included in the test itself or in the E/M service that he billed when the patient presented for testing.

Many practices conduct Protime tests with blood they collect using a capillary stick (36416, Collection of capillary blood specimen [e.g., finger, heel, ear stick]) instead of venipuncture (36415, Collection of venous blood by venipuncture).

You should check with your nurse to confirm that she collects this blood by venipuncture. Blood collection by finger, heel or ear stick is not payable by Medicare and many other payers.