Coding Analysis for Labs (CAL) View Public Comments

Prothrombin Time (PT) (Addition of ICD-9-CM V58.83, Encounter for therapeutic drug monitoring, as a covered indication)

Public Comments

Commenter Comment Information
J, Sharon Title: certified profession coder, practice coordinator
Organization: Delcom Practice Management
Date: 08/23/2006
Comment:

There is another diagnosis code that has come to my attention is not a covered code for a Prothrombin test (85610). That diagnosis code is 289.81, which covers a list of hypercoagulable conditions. In these case, patients are at risk for developing blood clots and are thus put on Coumadin. Therefore the PT results need to be monitored periodically and medication adjustment made as necessary. I do not understand why this code is not yet covered.

McBride, Lyn Title: Coding Supervisor
Organization: Sacred Heart Medical Center
Date: 07/31/2006
Comment:

We have an anticoagulation clinic in our facility. Often, patients are brought in specifically for monitoring of PT/PTT. Do you have another suggestion as to what diagnosis we would code. The attending MD generally sends one order good for the year that may or may not include the reason for the patient's anticoagulation. For patients who are sent for a one time lab draw, we try to query the physician. Your proposal presents some challenges! It will definitely hold up billing and we still

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