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Oncology & Hematology Coding Alert

Reader Question:

Forget About 99363 Payment From CMS

Published on Thu Mar 01, 2007

Question: I-ve had no luck getting paid for the new Coumadin management codes. Am I missing something here?

California Subscriber


Answer: CMS announced Status B (bundled) for the Coumadin management codes added in 2007:

- 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)

- 99364 -- ... each subsequent 90 days of therapy (must include a minimum of 3 INR measurements).

The bundled status means that CMS won't pay you separately for these codes. Private payers may reimburse you, so you should check with individual payers to be sure.
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