Cardiology Coding Alert

Question: According to the medical decision-making (MDM) section of an E/M visit and the table of risk, prescription drug management is "moderate complexity," and drug therapy, requiring intensive monitoring for toxicity, is "high complexity." Given that, where do Coumadin management and Amiodarone management fall -- moderate or complex?

Ohio Subscriber

Answer: Amiodarone is probably one of the best cardiology-specific examples of drug therapy that requires intensive monitoring for toxicity. Coumadin is a drug that modifies the patient's blood-clotting capabilities.

Physicians frequently perform Protime studies to measure the patient's Coumadin level. But physicians use this frequent monitoring to gauge the appropriate dose and to keep the Coumadin levels in a therapeutic range. Coumadin monitoring is different from monitoring for toxicity, so Coumadin would be considered a moderate-complexity drug, as far as the table of risk is concerned.