finger stick protimes

Is there a different cpt code that should be used when performing a finger stick protime rather than the usual 85610? Does Medicare pay the same for both procedures?

finger stick

Medicare does not recognize or pay separately for capillary (e.g., finger, heel) blood specimen collection (CPT code 36416). Private plans and Medicaid programs may, so you should check with the individual plan or program for guidance

billing of finger stick Protimes

I realize the fingerstick is not recognized but what about the test itself? Do you bill out the regular CPT code 85610? Are the reimbursements the same?

Pro time

Payment for traditional Medicare Part B lab tests is made according to a fixed fee schedule published annually by CMS per CPT lab code (ex, 85610). Medicare pays 100% of the fee schedule amount or the charge submitted– whichever is less. Submit- Laboratory assessment of PT/INR (i.e., CPT: 85610, “Prothrombin time”), the QW modifier states it is a waived test if performed in office.

and don't forget

99211 if you document properly