Heparin - MDM Level Of Risk - Parenteral Controlled Substances

[sdifuh278652]

Hello,

Is this correct about MDM:

Patient 1: age 35

Labs performed (low).

Treated for: Exacerbation of chronic atrial fibrillation (moderate - chronic illness with exacerbation)

Treated with: Heparin (high – parenteral controlled substances).

Level: Moderate (Low, moderate, high)



Patient 2: age 35

Labs performed (low).

Treated for: Pulmonary embolism (high - acute illness or injury that poses a threat to life or bodily function)

Treated with: Heparin (high – parenteral controlled substances).

Level: High (Low, high, high)



Question: is it correct to say that heparin is always counted as a parenteral controlled substance and is therefore always high risk in MDM?

“Controlled Substance – a schedule I, II, III, IV, or V drug or other substance. Parenteral – substance administered/given by a route other than the alimentary canal.” Source: UFJPI Administration Policy Template

 

[jkyles]

Hi there, a couple of things:
1. Heparin is not a controlled substance. https://www.dea.gov/drug-information/drug-scheduling (there's a link to the DEA's list of controlled substances at the bottom).
2. It is not correct to say that any parenteral controlled substance is always high risk. See the information for parenteral controlled substances in the E/M guidelines in the current CPT manual.

 

[sdifuh278652]

Hello,

What about heparin being a drug that requires monitoring for toxicity? Could it always be considered high risk then?

AAPC - Parenteral controlled substance in ED

I referred to the above thread and it is for the ED and is from several years ago. I wanted to make sure that this thread doesn't conflict with today. For some conditions, heparin is a more risky treatment than others, such as Eliquis. Since the usual thought processes could be treating a patient with heparin, it doesn't seem to mean that heparin is always high risk.