![]() Instead, it includes an assigned value for typical Time test cannot bill a separate E/M service. A physician who calls a patient to relay test results and schedule the next prothrombin ![]() Separate billing for anticoagulant monitoring management by phone. Physicians for anticoagulant monitoring management: The following scenarios illustrate how Medicare reimburses Q: How does Medicare pay for anticoagulant therapy?Ī: Anticoagulant monitoring services that are bundled into payment for an evaluationĪnd management (E/M) service include interpreting test results, evaluating the patientĪnd adjusting dosages. If he or she operates with a CLIA certificate of waiver. The prothrombin time test, billed as CPT 85610-QW, is payable to the physician Its payment for the test is based on the geographically specific laboratory test fee Patients on anticoagulant drugs, Medicare pays the entity that performed the test. Q: What code should I use to report the lab test itself? Is the lab test reimbursableĪ: When physicians use a prothrombin time test (reported with CPT code 85610) to monitor ICD-9 code V67.51 (following completed treatment with high-risk medication, not elsewhereĬlassified) should be reported only after patients have completed their drug treatment, ICD-9 codes 427.31 (atrial fibrillation) andĤ15.10 (pulmonary embolism and infarction) are examples of codes that could be used Should report the ICD-9 code indicating the condition for which an anticoagulant is Of anticoagulants, as the primary reason for ordering a prothrombin time test. Instructs that physicians should report ICD-9 code V58.61, long-term (current) use Contrary to what is published in the 2010 ICD-9-CM, Medicare Is this correct?Ī: Not for Medicare claims. Pulmonary embolism) as the primary diagnosis. Of Diseases, Ninth Revision (ICD-9) code for the disease process (e.g., atrial fibrillation, Q: When I bill for a prothrombin time test using the Current Procedural Terminology (CPT)Ĭode 85610, my reference laboratory wants me to provide an International Classification Will focus on the Medicare coding and payment policies. Payment policies differ among government and private insurers. There are essentially three parts to coding: diagnosis, lab tests and anticoagulation One of the trickiest coding scenarios for physician practices is anticoagulant therapy.
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