I am in agreement with Debra on this topic. The 85610 has a brief history (obtaining vitals) and exam component as part of the procedure as the global status code is XXX. Per the CMS guidelines in the NCCI Coding Policy Manual, General Coding Policies, Chapter 1. (eff. Jan. 1, 2014)
This E&M service may be related to the same diagnosis necessitating performance of the ?XXX? procedure but cannot include any work inherent in the ?XXX? procedure, supervision of others performing the ?XXX? procedure, or time for interpreting the result of the ?XXX? procedure. - CMS
Novitas-An evaluation and management (E/M) service (99211)
would be allowable if it is determined that the patient's medication needs adjustment, the INR is not therapeutic, or if the patient has symptoms that need to be addressed.
The billing of an E/M service in addition to obtaining the clinical specimen (phlebotomy or finger stick) is not medically reasonable and necessary if the following conditions are met:
If the INR is within the therapeutic range, and
1. the documentation does not support a need for adjustment of warfarin dosage, or
2. the documentation does not support that the patient is symptomatic, or
3. the documentation does not support the presence of a new medical co-morbidity or dietary change.
Rather, information may be relayed to the beneficiary telephonically, and there is no need for a face-to-face E/M service.
http://www.novitas-solutions.com/webcenter
Noridian "might" allow it per their guidelines. This would need to be a facility decision to allow billing for nursing work prior to an INR check performed in the office.
https://www.noridianmedicare.com/provider/updates/docs/incident_to_billing_99211_acro.pdf