tci Part B Insider - 2015 Issue 2

Reader Question: 85610 Works for Coumadin Monitoring

Question: A patient with deep venous thrombosis (DVT) is on Coumadin for blood thinning. We perform a prothrombin time test once a week to monitor Coumadin levels. How should we code this? Answer: The correct code for the prothrombin time test is 85610 (Prothrombin time). If this is done in a physician office lab that operates with a certificate of waiver under the Clinical Laboratory Improvement Amendments (CLIA), then you should report the code with modifier QW (CLIA waived test). You’ll need documentation of the patient’s DVT and Coumadin (Warfarin sodium) treatment to show medical necessity for...

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