Coumadin Clinic - low level E&M


Albuquerque, NM
Best answers
I am billing a 99211 with 85610 in our coumadin clinic. We have a payor that is stating we are coding incorrectly by charging a low level E&M and we should be using another code. Can someone help by either telling me where I can find documentation that states we are using correct coding or direct me to the other code.
Coumadin Clinic

We use codes 36416 and 85610 (with QW modifier if Medicare), when provider does not see pt. If provider sees pt w/use 99211-99215 w/25 modifier, 36416, and 85610.

Use only the E&M code if the cap stick and ProTime were done elsewhere.

coumadin clinic

i use v5883,v58.61, and then the reason the pt is on coumadin and also most of our pts dont see dr when they come in for this. CODING EDGE FROM FEB 2007 TALKS ABOUT COUMADIN MANAGEMENT AND WHAT CODE TO BILL OUT.