How To Use CPT Code 93793

CPT 93793 involves anticoagulant management for patients taking warfarin, including review and interpretation of INR test results, patient instructions, dosage adjustments, and scheduling additional tests. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 93793.

1. What is CPT 93793?

CPT 93793 is a medical billing code used for anticoagulant management services provided to patients taking warfarin. This code covers the 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.

2. 93793 CPT code description

The official description of CPT code 93793 is: “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.”

3. Procedure

The 93793 procedure involves the following steps:

1. Review and interpretation of a new INR test result obtained from patient home monitoring, office monitoring, or a lab result.
2. Adjustment of the anticoagulant warfarin dosage if necessary based on the test result.
3. Communication of the test results to the patient and providing instructions regarding any changes in dosage or treatment plan.
4. Scheduling additional tests if needed.

4. Qualifying circumstances

Patients eligible to receive CPT code 93793 services are those who are taking regular doses of warfarin for anticoagulation management. These patients must have a new INR test result available for review and interpretation by the healthcare provider. The INR test result can be obtained through home monitoring, office monitoring, or a lab result.

5. When to use CPT code 93793

It is appropriate to bill the 93793 CPT code when a healthcare provider reviews and interprets a new INR test result for a patient taking warfarin, provides instructions to the patient regarding any necessary dosage adjustments, and schedules additional tests if needed. This code should not be reported in conjunction with certain evaluation and management codes, as specified in the CPT guidelines.

6. Documentation requirements

To support a claim for CPT 93793, the following information should be documented:

• Date of service
• INR test result (home, office, or lab)
• Review and interpretation of the INR test result by the healthcare provider
• Any necessary dosage adjustments based on the test result
• Patient instructions regarding treatment plan and dosage changes
• Scheduling of additional tests, if needed

7. Billing guidelines

When billing for CPT code 93793, it is important to follow the guidelines and rules set forth by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). CPT 93793 should not be reported in conjunction with certain evaluation and management codes, as specified in the CPT guidelines. Additionally, this code should be reported no more than once per day, regardless of the number of tests reviewed.

8. Historical information

CPT 93793 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to this code since its addition.

9. Similar codes to CPT 93793

Five similar codes to CPT 93793 and how they differentiate are:

1. CPT 93792: This code is used for home INR initiation, face-to-face training, and documentation of the patient’s or caregiver’s ability to obtain blood samples, perform testing, and report results.
2. CPT 99201-99205: These codes are used for new patient office or other outpatient services and should not be reported in conjunction with CPT 93793.
3. CPT 99211-99215: These codes are used for established patient office or other outpatient services and should not be reported in conjunction with CPT 93793.
4. CPT 99242-99245: These codes are used for office or other outpatient consultations and should not be reported in conjunction with CPT 93793.

10. Examples

Here are 10 detailed examples of CPT code 93793 procedures:

1. A patient taking warfarin has a new INR test result from home monitoring. The healthcare provider reviews the result, adjusts the dosage, and schedules a follow-up test.
2. A patient visits the healthcare provider’s office for an INR test. The provider reviews the result, provides instructions on dosage adjustments, and schedules a follow-up test.
3. A patient’s lab result for an INR test is sent to the healthcare provider. The provider reviews the result, adjusts the dosage, and schedules a follow-up test.
4. A patient taking warfarin has a new INR test result from home monitoring. The healthcare provider reviews the result, determines no dosage adjustment is needed, and schedules a follow-up test.
5. A patient visits the healthcare provider’s office for an INR test. The provider reviews the result, provides instructions on maintaining the current dosage, and schedules a follow-up test.
6. A patient’s lab result for an INR test is sent to the healthcare provider. The provider reviews the result, determines no dosage adjustment is needed, and schedules a follow-up test.
7. A patient taking warfarin has a new INR test result from home monitoring. The healthcare provider reviews the result, adjusts the dosage, and provides instructions on the new treatment plan.
8. A patient visits the healthcare provider’s office for an INR test. The provider reviews the result, provides instructions on dosage adjustments, and discusses the new treatment plan.
9. A patient’s lab result for an INR test is sent to the healthcare provider. The provider reviews the result, adjusts the dosage, and provides instructions on the new treatment plan.
10. A patient taking warfarin has a new INR test result from home monitoring. The healthcare provider reviews the result, determines no dosage adjustment is needed, and provides instructions on maintaining the current treatment plan.