Medical Coding

Category - Evaluation and Management

A 54-year-old patient on Warfarin is being routinely followed by having international normalized ratio (INR) testing done, with the physician reviewing and adjusting medication dosing as needed. This is done through the physician’s office on an outpatient basis. The patient is in her first 90 days of therapy and has had nine INR measurements done at this time. What is the correct evaluation and management code for this encounter?
  1. 99360
  2. 99363
  3. 99364
  4. 99366
Explanation
Answer: B - 99363 is the correct code for the initial 90 days of Warfarin therapy with a minimum of eight INR measurements.
Code 99360 is incorrect because this code is used for standby services. Code 99364 is incorrect because this code is the “add-on” code for anticoagulant management services for every subsequent 90 days, after the first which must include a minimum of three INR measurements. Code 99366 is incorrect because this code is regarding medical team conferences.
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