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Thread: Coumadin Mgmt code?

  1. #1

    Exclamation Coumadin Mgmt code?

    AAPC: Back to School
    Is there a way to bill for coumdin management?. Pt is on coumadin for DVT and my provider has been managing this for the last 3 months

    Thank you,
    Susan G

  2. #2

    Default Coumadin question

    Yes, you can bill for coumadin management. As long as you are testing the patient's blood for pt/inr you can bill 85610. Our rn performs the test, does bp & weight and we also bill a minimal office visit of 99211. (physician must be on site). All is documented with patient's next dose advisment of coumadin and next time to be checked.

  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    Much is written about the use of the 99211 for a blood draw encounter in that this is not appropriate. Just because a nurse takes vitals is not criteria for a 99211. The physician ordered the patient to have the blood r=draw performed so when they come back for this the nurse is following the order for a predetermined activity for which a code already exisits.. that is a blood draw either 36415 or 36416. You cannot substitute codes for better paying ones. There was a Decision Heath article written by the compliance officer for CMS which states that you may not charge a 99211 for a blood draw encounter. This was written in Feb 11, 2002.
    However if you are callings this a coumadin enccounter then, you may use the 99211 but the nurse must document: (and not with a check list)
    She checked the patient's body for bruising (entire body)
    she discusses the patient's diet and compiancle with the physician ordered diet
    she discusses all the patient's medications and their compliance with their medication regime
    she documentes the blood draw
    she documents the past result as well as todays, plus any discussion with the phsycician regarding a change in plan...
    All this must be performed while the patient is in the office and not over the phone.
    THEN you may bill a 99211 and the 85610.

    Debra A. Mitchell, MSPH, CPC-H

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