# Drug monitoring for toxicity



## LindaEV

I very recently heard in a teleconference or a webinar that there is a list available of "drugs that require intensive monitoring for toxicity" and that coumadin was NOT on it.  Unfortunaltely I can find my note, or remember the source. Does anyone know if such a list truly exists?


----------



## Lisa Bledsoe

V58.61 is specically for anticoagulants (coumadin).


----------



## mitchellde

LINDALOUV said:


> I very recently heard in a teleconference or a webinar that there is a list available of "drugs that require intensive monitoring for toxicity" and that coumadin was NOT on it.  Unfortunaltely I can find my note, or remember the source. Does anyone know if such a list truly exists?



I cannot imagine that such a list does exist, the doctor I questioned stated that any and all drugs need to be monitored for toxicity, it is just the manner in which they are monitored.  Sometimes you just observe or examine the patient other times you draw labs, or get urine samples, or even a diagnostic study. 
According to coding clinics drug monitoring regardless of how it is being performed should be coded to V58.83 followed by the V58.6x code.  V58.6x is secondary only allowed.


----------



## LindaEV

Thanks for responding ladies.

The actual reason I ask is for use when it comes to determining risk during an audit. In the "HIGH" risk column it lists "drug therapy requiring intensive monitoring for toxicity"

I have a rheumatologist who list this in his assesment almost everytime.
I have Fam Prac docs who use this statement as well, especially for Coumadin.

When auditing this is often the deciding factor for a level 5. I was jus wondering as far as the table of risk goes, how I would determine to give credit for this during a chart audit.


----------



## FTessaBartels

*INTENSIVE monitoring*

To me the key here is "INTENSIVE" monitoring for toxicity.

I interpret that as being virtually continuous monitoring of the type done in a hospital or office setting.  Not the kind of monitoring that is done by having the patient return on a regular basis for blood work or other checks of drug levels/advserse effects. 

Just my opinion/interpretation.

F Tessa Bartels, CPC, CEMC


----------



## eJones317

http://www.palmettogba.com/Palmetto/Providers.nsf/files/Drug_Therapy_Requiring_Intensive_Monitoring_for_Toxicity.pdf/$FIle/Drug_Therapy_Requiring_Intensive_Monitoring_for_Toxicity.pdf

I found this list when researching this subject as well as this forum.
I hope this helps.


----------



## colorectal surgeon

Very interesting list/post. Thanks for posting.


----------



## ldbraziel@sbcglobal.net

*Drug monitoring for toxicity Reply*

Here is a link for Palmetto regarding a table of risk lists drug therapy requiring intensive monitoring: http://www.palmettogba.com/Palmetto...tensive Monitoring for Toxicity?open&Expand=1


----------

