2025 CPT code 93793
(Active) Effective Date: N/A Revision Date: N/A Medicine - Anticoagulant Management Medicine Services and Procedures > Cardiovascular Procedures Feed
Management of warfarin therapy, including INR test result review, patient instructions, dosage adjustments, and scheduling additional tests.
Modifiers may apply depending on the circumstances of service, such as modifier 25 for a significantly separate E/M service performed on the same day.
Medical necessity for code 93793 is established when a patient requires ongoing management of warfarin therapy to prevent thromboembolic events or bleeding complications.Appropriate documentation is crucial to demonstrate medical necessity to payers.
The physician or qualified healthcare professional is responsible for reviewing the INR results, interpreting their clinical significance, providing patient education on warfarin management, making appropriate dosage adjustments, and scheduling any necessary follow-up appointments.
- Medicine Services and Procedures > Cardiovascular Procedures
- Medicine Services and Procedures > Cardiovascular Procedures
In simple words: The doctor checks your blood test results to see how well your blood thinner (warfarin) is working. They explain the results, adjust your medicine dose if needed, and tell you what to do. They also schedule your next blood test.
This CPT code encompasses the comprehensive management of a patient's anticoagulation therapy with warfarin.It mandates the review and interpretation of a new international normalized ratio (INR) test result, whether obtained at home, in the office, or from an external laboratory. The service includes providing necessary patient instructions, making dosage adjustments as clinically indicated, and scheduling follow-up testing appointments.All components must be performed for accurate billing.
Example 1: A patient with atrial fibrillation is on warfarin therapy.Their home INR test shows a subtherapeutic result. The physician reviews the result, provides patient education about the importance of therapeutic INR range, adjusts the warfarin dosage, and schedules a follow-up INR test in a week., A patient with a mechanical heart valve is being monitored for warfarin therapy. Their INR result is supratherapeutic. The physician reviews the result, educates the patient on bleeding precautions, adjusts their warfarin dose downward, and schedules a follow-up INR test in 2 days., A patient with a history of deep vein thrombosis (DVT) is started on warfarin. The physician initiates home INR monitoring, provides the patient with training and education on self-monitoring, and schedules a follow-up visit to review the initial INR result.
* Complete patient history including medical conditions, medications, and allergies.* Documentation of the INR test result(s).* Documentation of patient education provided regarding warfarin management, including signs and symptoms of bleeding, diet restrictions, and drug interactions.* Documentation of dosage adjustments made, including rationale and the new prescribed dose.* Documentation of scheduled follow-up appointments.
** Ensure compliance with all payer-specific guidelines and requirements for reimbursement.Thorough documentation is crucial for appropriate coding and payment.
- Revenue Code: M5D (SPECIALIST - OTHER)
- RVU: This information is not available in the provided source. Consult the current CPT codebook or other relevant resources for RVU data.
- Global Days: This information is not available in the provided source.The global period may vary depending on payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: This information is not explicitly provided, but based on the nature of the service, a technical component (TC) modifier would likely not be applicable.
- Fee Schedule: This information is not available in the provided source.
- Specialties:Cardiology, Hematology, Internal Medicine, Family Medicine
- Place of Service:Office, Home, Other