Oncology & Hematology Coding Alert

Watch the diagnosis -- you may be surprised at the first-listed code. Don't get stuck with the bill for your hematologist's in-office monitoring of Coumadin use -- instead, learn the Coumadin coding ropes. One surefire way is to follow these three key guidelines. 1. Put Proper Code to Periodic PT Test "Physicians often use PT [prothrombin time] to assess patient response to the drug warfarin," says Barb Miller, MT (ASCP) SH, with Nebraska Medical Center. When patients on warfarin therapy come to your "Coumadin clinic" for periodic testing to assess their anticoagulation status, you should report 85610 (Prothrombin time) for the test. Remember the modifier: Be sure to append modifier QW (CLIA waived test) to 85610 (and that you operate with a CLIA certificate of waiver). If the nurse needs to evaluate new symptoms such as bruising or bleeding -- something beyond the basic PT visit -- code 99211 (Office or other outpatient visit [...]