Oncology & Hematology Coding Alert

Count INR measurements to ensure coding accuracy

You-ll have two new codes to report anticoagulant management for patients taking warfarin beginning in January 2007.

The codes include physician review and interpretation of the International Normalized Ratio (INR) testing, plus patient instructions, dosage adjustment and ordering of additional tests.

Code 99363 (Anticoagulant management for an outpatient taking warfarin, physician review and interpretation of International Normalized Ratio [INR] testing, patient instructions, dosage adjustment [as needed], and ordering of additional tests; initial 90 days of therapy [must include a minimum of 8 INR measurements]) covers the first 90 days, including at least eight INR measurements.

Code 99364 (- each subsequent 90 days of therapy [must include a minimum of 3 INR measurements]) covers each additional 90 days and requires a minimum of three INR measurements.

In the past, you haven't had a code to describe anticoagulant management, and some coders have caused controversy by using 99211 (Office or other outpatient visit ...) for this service, says Sheldrian Leflore, revenue management educator with The Coding Group, a division of IRM in Carlsbad, Calif.

More changes: The descriptors for inpatient consultation codes 99251-99255 delete the word -initial- to account for the fact that last year's CPT update deleted the follow-up inpatient consultation codes.