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99211 Anticoagulation managment

  1. #11
    Columbia, MO
    Medical Coding Books
    for the 99363 and 99364, you can bill these every 90 days and not a day shy of 90 for Medicare to pay. We have had no problems with Medicare paying for these codes. You bill the initial 90 after the visit where the Coumadin is first prescribed as long as you have a minimum of 8 PT/INR results, then 90 days after that you can bill the 99364 as long as you have 3 PT/INR results within that 90 days and so on. If the pt's coumadin is interrupted for inpt admit or surgery or for whatever reason the the entire process starts all over, you have the visit where the coumadin is restarted, then 90 days after that with 8 results on the chart you bill the 99363 and so on.

    As far as the 99211, in 2002 on Feb11, Kathleen Mueller (compliance officer for CMS) wrote an article for Decision Health as a special report on the 99211. In this article she expressed that it is incorrect to charge a 99211 for blood draw encounters. Even if the nurse checks vital signs.

    Debra A. Mitchell, MSPH, CPC-H

  2. #12
    Seacoast- Dover New Hampshire
    Has there been any update since 2002?
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #13
    Columbia, MO
    none that I am aware of. I try to stay very up to date on this type of issue.

    Debra A. Mitchell, MSPH, CPC-H

  4. #14
    hickory coding chapter
    Mitchellde --what are your thoughts on this, my ortho doc wants to bill 99363 for our postop patients that are enrolled in home health, he is managing /adjusts PT INR for. Is this the appropriate code to be billing b/c the pt is not face to face.

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