AAPC - Back to school
Results 1 to 3 of 3

Thread: Coumadin coding

  1. #1

    Default Coumadin coding

    AAPC: Back to School
    I need some advice

    we have rn's who perform coag checks 85610qw. Are we allowed to bill for the the finger stick 36416? What is the customary charge for this service?

    I see that it is not a paying code on the mc fee schedule.

    Also what are your thoughts in regards to billing a 99211? What are your thoughts on the required documentation?

    With the advent of ehr are checking boxes enough?


  2. #2
    Join Date
    Apr 2007
    Leesburg, VA


    We bill the following:

    36415 - 59
    85610 - QW

    Please check with your carrier about billing 99211. Our region is covered by Highmark Medicare Services and we are only able to charge the 99211 if the medication needs adjustment, the INR is not therapeutic, or if the patient has symptoms that need to be addressed. The Doctor has to make a note indicating the adjustment in medication and sign off in the record for 99211.

    We are allowed to bill the 36415, but it must have a modifier 59 or our carrier will not process it for payment. Hope this helps!


  3. #3
    Join Date
    Apr 2007
    Columbia, MO


    You should not use the 99211 for a blood draw encounter as there is the code for that, the 36415 or 36416. For a nurse to see a patient that has symptoms or needs to address INR that is not in therapeutic range is out of her scope of licensure. A nurse is not licensed to evaluated a complaint and diagnose and treat it. This must be face to face with the physician.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. PE and coumadin
    By rroblin in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 03-09-2012, 09:08 AM
  2. Coumadin Mgmt coding
    By sgormsen in forum Internal Medicine
    Replies: 1
    Last Post: 09-01-2010, 10:11 PM
  3. Coumadin Therapy Correct coding sequence
    By NAKARAK2 in forum Medicare Regulations
    Replies: 3
    Last Post: 12-28-2009, 07:06 AM
  4. Coumadin maintenance
    By rradeke in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 04-02-2009, 09:57 AM
  5. Coding for Coumadin Therapy
    By tamyrahitz in forum Orthopaedics
    Replies: 0
    Last Post: 06-09-2008, 09:28 AM

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?


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.