EM Coding Alert

Question: In the E/M Table of Risk, where does prescription drug management of Coumadin fall?

North Carolina Subscriber

Answer: North Carolina’s Part B Medicare administrative contractor (MAC) Palmetto has posted a Q&A stating that “Coumadin is considered a ‘drug therapy requiring intensive monitoring for toxicity.’” In the Table of Risk, that puts Coumadin in the High Risk category.

Documentation should include drug levels taken at appropriate intervals, according to Palmetto.

Caution: All of your E/M coding should be based on the specific patient encounter, so if the provider doesn’t consider the Coumadin management to be high risk, you should code in line with the provider’s assessment.