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99211 Anticoagulation Management

  1. Question 99211 Anticoagulation Management
    Medical Coding Books
    Jan 6 2011 received cominique from MC "CPT code 99211 may not be routinely submitted for monitoring anticoagualtion management."

    First a little background, for Coumadin Therapy our patients see an nurse are ascessed for problems, bruising etc, vitals are taken and current meds are checked along with PT/INR. Dosages are changed if needed by office protocols. 99211 is charged along with PT/INR.

    With this communique, the way I am interpreting it is that no longer can we charge the 99211 if the INR is within a controlled range. This will either cause the need to continue to employee a nurse but loose revenue because the controlled level visits can not be charged, or will cause the physician to be called in to review the uncontrolled and a higher level of service 99212,99213.

    The physicians do not want to change the way we are doing Coumadin therapy but I have directed that we must and they need to decide how they want Anticoagulation management handled ASAP.

    I would appreciate any input anyone can give as to how your practice is handeling Coumadin Therapy.


  2. #2
    Evansville Indiana
    Default 99211
    We were advised to only charge 99211 when there was a new symptom or change in dosage and then the next appt to assess the change. On the other visits only the lab would be charged.

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