By:Jacqueline Thelian, CPC, CPC-I, CHCA
CPT 2018 introduces new codes for home and outpatient International Normalized Ratio (INR) services. The new codes are more user friendly than the former INR CPT codes 99363 and 99364 which were deleted for 2018.
The new codes include the ordering, review, and interpretation of new INR test result(s), patient instructions, and dosage adjustments as needed.
An Evaluation & Management (E/M) code may be reported in addition to the new codes as long as the E/M is significant and separately identifiable. Additionally, the codes do not include the provision of the test materials and equipment which is reported separately.
Unlike the former INR codes which required physician review the new codes may be performed by the clinical staff under the direction of a physician or qualified healthcare professional.
The new codes are:
93792 Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the INR monitor, obtaining blood sample, instructions for reporting home INR test results, and documentation of patient's/caregiver’s ability to perform testing and report results
93793 Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (INR) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed
The best news is saved for last as CMS recognizes and reimburses for the new codes. The national reimbursement rate for CPT code 93792 is $55.06 and CPT code 93793 reimburses nationally at $12.24. You can search for reimbursement rates for your locality on the CMS Physician Fee Schedule Look Up Tool by going to:
Current Procedural Terminology (CPT) 2018
CMS Physician Fee Schedule Look Up Tool