Page 1 of 3 123 LastLast
Results 1 to 10 of 23

PT/INR Monitering

  1. Smile PT/INR Monitering
    Exam Training Packages
    Hi Everyone,

    I was looking in the coding book and found two codes for PT/INR monitering and ordering of medicines. They are 99363 and 99364. Has anyone every used this codes? If so can you please let me know how you go about billing this...

    We are a cardiology practice who has about 100 patients on coumadin and we call them the previous day with orders from the doctor and then also call in coumadin medicine to pharmacy.

    Please help in anyway.

    Thanks,

    Tina Loughary

  2. #2
    Location
    Columbia, MO
    Posts
    12,560
    Default
    These are for physician face to face with patient encounters. Medicare's unadjusted rate last year was $104 for the 99363 and 40 for the 99364. You need to read up on these to know how to use them. cliff notes version. The initial encounter to give the dx and order the coumadin is day 1 and 90 days from day 1 with a minimum of 8 PT/INR results on the chart you can bill a 99363 for a physician encounter. Then 90 days from that encounter with minimum of 3 PT/INR results you may bill a 99364 for a physician encounter, and then a 99364 for each 90 days after. If the therapy is stopped for any reason then when it is restarted that encounter is day 1 and the whole process begins again.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    We bill them as appropriate, what Debra said, is all true. But, (always a But), just because it is in the code book many insurance do NOT pay for them. aka Medicare does not cover. Yet, some do, you have to weigh if it is all worth it for you.

  4. Default
    Hi Heather, Do you know what insurances will cover the 99363 and 64?

  5. #5
    Default
    we bill 85610. hmo plans will not pay have to go to outside lab. other then that we get paid.

  6. #6
    Location
    Columbia, MO
    Posts
    12,560
    Default
    I have not had any problem with Medicare reimbursing for these codes are you getting a denial that states it is not covered?

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Default
    mitchellde if you are asking me....

    yes we get denials from bcbs hmo, oxford hmo. straight mcare does pay. denial is non covered service, must go to outside lab.

  8. #8
    Location
    Columbia, MO
    Posts
    12,560
    Default
    that is for the lab code, what about the 99363-4 I have never been denied by carrier. I have been asked for the documentation but have always received the reimbursement.

    Debra A. Mitchell, MSPH, CPC-H

  9. #9
    Default
    what's the differance between the 99393 99394 or using the 85610 beside reimbursment??? kinda new at cardiology coding and only know of the 85610.

  10. #10
    Location
    Columbia, MO
    Posts
    12,560
    Default
    the 85610 is for the lab and 99393-4 is the physician face to face with the patient.

    Debra A. Mitchell, MSPH, CPC-H

Page 1 of 3 123 LastLast

Similar Threads

  1. Drug monitering
    By Linda McMann in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-13-2014, 07:17 PM
  2. EMG monitering the tongue
    By terribadalament in forum Neurology/Neurosurgery
    Replies: 1
    Last Post: 05-06-2013, 08:58 PM
  3. Intra-operative Monitering (IOM)
    By brieghm in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-30-2010, 09:40 PM
  4. Inr
    By PLAIDMAN in forum Pathology & Clinical Laboratory
    Replies: 1
    Last Post: 08-05-2010, 01:00 PM
  5. Pt/inr - I have instructed my nurse
    By jnieto625 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 05-14-2010, 02:57 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.