ERA denial code - N390, MA101, N 103, MA31, M86, N435 with description

Denial code 107, 109, 110,115, 119 remark codes

Adj. Reason Code	Adj. Reason Code Description	Remark Code	Remark Code Descripton	Exception Code Descripton
107	The related or qualifying claim/service was not identified on this claim.	N390	This service/report cannot be billed separately.	PROLONGED SERVICES
				MUST HAVE ANESTHESIA SERV
				CHEC PROCEDURE CODE NOT FOUND
107	The related or qualifying claim/service was not identified on this claim.			MUST BILL IMMUNIZATION CODE - VFC
				MUST BILL WITH D9220
109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.	MA101	A SNF is responsible for payment of outside providers who furnish these services/supplies to residents.	SERVICES COVERED IN ICF/MR PER DIEM
				NH PAID A PORTION OF CLAIM AMOUNT
109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.	N103	Social Security records indicate that this patient was a prisoner when the service was rendered. This payer does not cover items and services furnished to an individual while they are in State or local custody under a penal authority, unless under State or local law, the individual is personally liable for the cost of his or her health care while incarcerated and the State or local government pursues such debt in the same way and with the same vigor as any other debt.	ADULT CRIMINAL COURT JURISDICTION
				JUVENILE CRIMINAL COURT JURIS.
109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.	N192	Patient is a Medicaid/Qualified Medicare Beneficiary.	MEDICARE ELIGIBLE CLIENT, BILL PT D PLAN
109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.			HCBS MUST BE ON TAPE
				NOT EXEMPTED SUB ADOPT BILL PMHP OR DHS
				MENTAL HEALTH SERVICES
110	Billing date predates service date.	MA31	Missing/incomplete/invalid beginning and ending dates of the period billed.	SVC DATE AFTER CLAIM RECEIVED
110	Billing date predates service date.			INVALID BILLING DATE
				LAST DATE OF SERV > BILLING DT
115	Procedure postponed, canceled, or delayed.			RECIPIENT DID NOT ENTER NH FAC.
119	Benefit maximum for this time period or occurrence has been reached.	M123	Missing/incomplete/invalid name, strength, or dosage of the drug furnished.	LONG ACTING NARCOTIC DRUG INTERACTION
119	Benefit maximum for this time period or occurrence has been reached.	M86	Service denied because payment already made for same/similar procedure within set time frame.	HOME HLTH INITIAL VISIT > 1 PER ADMIN
				HOME HEALTH SUPPLIES EXCEEDS ALLOWABLE
				SERVICE EXCEEDS 6 PER 12 MONTH LIMIT
				SERVICE EXCEEDS ONE PER MONTH
				LITHOTRIPSY 2 PR 90 DAY LIMIT
				LITHOTRIPSY 2 PER 90 DAYS/UB82
				HOSPICE - 1 PER DAY LIMIT
				EXCEEDS 3 PR 3 CALENDR MNTH LMT
				SCHOOL SRVCS - 1 PER DAY
				EXCEEDS HCBS 1 PR DY LMT
				EXCEEDS 1 CASE MGMT PER DAY
				EXCEEDS X-RAY LIMITS
				1 PER DAY LIMIT
				D7110 1 PR DAY LMT EXCD
119	Benefit maximum for this time period or occurrence has been reached.	M90	Not covered more than once in a 12 month period.	PREVENTIVE HEALTH EXAM - ONE PER YEAR
				VISION LIMIT EXCEEDED
119	Benefit maximum for this time period or occurrence has been reached.	N130	Consult plan benefit documents/guidelines for information about restrictions for this service.	PROC CD HAS UNIT LMT
				PCN CLIENT PRESCRIPTION LIMIT EXCEEDED
119	Benefit maximum for this time period or occurrence has been reached.	N20	Service not payable with other service rendered on the same date.	EXCEEDS XRAY LIMITS
119	Benefit maximum for this time period or occurrence has been reached.	N362	The number of days or Units of Service exceeds our acceptable maximum.	UNIT LIMIT EXCEEDED
				OBSERVATION SERVICES-1 PER 48 HR PERIOD
				EXCEEDS RESIDENCE LIMIT
				PROC CODE LIMITED TO 12 UNITS PER CAL YR
				LMT PR CALENDAR YR EXCEEDED
				HOSPICE UNITS EXCEED 5
119	Benefit maximum for this time period or occurrence has been reached.	N435	Exceeds number/frequency approved/allowed within time period without support documentation.	EXCEEDS 10 PER 12 MO. REQ. MANUAL REVIEW
119	Benefit maximum for this time period or occurrence has been reached.			RESPITE CARE LIMIT
				EXCEEDS 8 PER 24 MOS
				EXCEEDS DENTAL LIMIT-XRAY
				DENTAL LIMIT-2 EXAM PER YEAR
				EXCEEDS PROPHY LIMIT
				EXCEEDS SEALANT LIMIT
				EXCEEDS CROWN PREP LIMIT
				EXCEEDS CROWN LIMIT
				PERINATAL CRE CO-ORD EXCDS 1 PR 30 DYS
				RSK ASSMT EXCDS 2 PR 10 MOS
				GROUP PRE/POSTNATAL ED EXCDS 8 PR 12 MOS
				DIET COUNSL EXCEEDS 14 PER 12 MOS
				PSYCHOSOCIAL COUSL EXCEEDS 10 PER 12 MOS
				PRE/POSTNATAL HOME VSTS EXCDS 6 PR 12 MS
				PRENATAL ASSMENT VSTS EXCDS 1 PR 10 MOS
				PRENATAL VISIT EXCDS 3 PR 10 MONS
				GLOBAL MTRNTY CRE 1 PR PRGNCY
				HIGH RSK MATERNITY GLOBAL-1 PER PREGNCY
				HGH RSK PREG CNSULT EXCDS 1 PR 10 MOS
				HGH RSK PREG FLLW-UP EXCDS 2 PR 12 MOS
				EXCEEDS 2 FOLLOW-UP PHONE CONTACTS SMKG
				ORIG LINE DENIED, EXCEEDS UNIT LIMIT

Medical record documentation tips

Tips for Medical Record Documentation

•    The medical record should be complete and legible, utilizing widely accepted and recognized abbreviations and symbols. It should also be dated and authenticated by the physician.

•    Documentation should support the intensity of the evaluation and/or treatment, including thought processes and the complexity of medical decision-making.

•    The codes recorded on the Medicare claim should be supported by the documentation in the medical record.

•    The patient’s progress including response to treatment, change in diagnosis and patient non-compliance should be documented.

•    Documentation of each encounter should include:
o    The patient’s name and date of service (including the backside of double-sided forms).
o    The reason for the encounter.
o    An appropriate history and physical exam including any relevant health risk factors.
o    The reason, results and review of diagnostic tests and ancillary services.
o    Patient assessment and a treatment plan, including a discharge plan (when appropriate). The written treatment plan should include: treatments and medications specifying frequency and dosage; labs and tests; referrals and consultations; patient/family education; and specific follow-up instructions.
o    The clear identity and professional credentials of all people who contributed to the service and/or record, and who contributed which portion(s) of the service and/or record.

An appropriately documented medical record can expedite claims processing, reduce errors and may serve as a legal document to verify the care provided, if necessary. In addition to the above general documentation tips, the following are links to minimum documentation recommendations based on specific services.

Remark code - N357, M119, M123, M2, M50, M54 & N129, N130, N19

Denial Code 45, 50, 54,58, 59, 60, 96, 97 and related remark codes

Adj. Reason Code	Adj. Reason Code Description	Remark Code	Remark Code Description	Exception Code Description
45	Charges exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. (Use Group Codes PR or CO depending upon liability).			SUBMITTED CHARGE ON 340B CLAIM TOO HIGH
50	These are non-covered services because this is not deemed a `medical necessity' by the payer.			RECIPIENT DENIED NO MEDICAL NEED
54	Multiple physicians/assistants are not covered in this case.			ASSISTANT SURGEON NOT COVERED
58	Treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.			RECIP DENIED INAPP PLCMNT
59	Processed based on multiple or concurrent procedure rules. (For example multiple surgery or diagnostic imaging, concurrent anesthesia).			TWO ANESTHESIA SERVICES
60	Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.	N357	Time frame requirements between this service/procedure/supply and a related service/procedure/supply have not been met.	INPT/OUTPT CONFLCT
				PAID OUTPT CLAIM CONFLICT
60	Charges for outpatient services are not covered when performed within a period of time prior to or after inpatient services.			OUTPT/DRG CONFLICT
				EMERGENCY ROOM NOT PAYABLE
				EMERG ROOM OTH/SVCS NOT PAYBLE
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M119	Missing/incomplete/invalid/deactivated/withdrawn National Drug Code (NDC).	DRUG DISCONTD- NO ALTERNATE
				DRUG DISCONTD-BILL REPLACEMENT
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M123	Missing/incomplete/invalid name, strength, or dosage of the drug furnished.	COMPOUND NOT COVERED FOR PROGRAM TYPE
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M2	Not paid separately when the patient is an inpatient.	INPT OT IS PART OF HOSP PYMT
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M50	Missing/incomplete/invalid revenue code(s).	NON-COVERED MCAID REVENUE CODE
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M54	Missing/incomplete/invalid total charges.	INVALID TOTAL NON/COV CHARGE
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M67	Missing/incomplete/invalid other procedure code(s).	OTHER SURG PROC NOT COVERED
				OTHER PROC NOT COVERED (81)
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	M79	Missing/incomplete/invalid charge.	XOVR CLM - CHIROPRACTOR NOT CVRD
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	MA66	Missing/incomplete/invalid principal procedure code.	PRINCIPAL SURG PROC NOT CVRD
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	N129	Not eligible due to the patient's age.	CHEC RECIPIENT AGE IS GREATER THAN 20
				INVAL RECIP AGE/DRUG(REF FILE)
				PROC NOT PAYABLE FOR AGE OR PROV TYPE
				TOOTH NOT COVERED FOR ROOT CANAL
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	N130	Consult plan benefit documents/guidelines for information about restrictions for this service.	INPT PSYC,REHAB/SURG CNFLCT
				X-OVER NOT COVERED FOR PCN
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	N216	We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package.	NONCOVERED MEDICAID BENFIT
96	Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).	N30	Patient ineligible for this service.	CUSTODY MEDICAL CARE CLAIMS
				CLAIM/REF FILE AID TYPE CONF
				EMERGENCY ONLY CLIENT NON COVERED SVC
				NURSING HOME CLAIM PCN ELIGIBLE
				INVALID PREGNANCY INDICATOR FOR DRUG
				NDC'S IN COMPOUND NON-COVERED
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M14	No separate payment for an injection administered during an office visit, and no payment for a full office visit if the patient only received an injection.	INJECTION/OFFICE CALL CONFLICT
				THERAPEUTIC INJECTION/OFFICE CALL CONFLICT
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	M86	Service denied because payment already made for same/similar procedure within set time frame.	GLOBAL/OTHER DELVRY CONFLICT
				GLOBAL ALREADY PAID
				TWO GLOBAL - SAME CYCLE
				GLOBAL CARE PAID
				SRVC INCLUDED IN GLOBAL
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N19	Procedure code incidental to primary procedure.	PAYMENT INCLUDED IN PRIMARY PROCEDURE
				CURRENT PROC INCIDNTL OTHER CURRENT PROC
				HIST PROC INCIDNTL OTHER CURRENT PROC
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N20	Service not payable with other service rendered on the same date.	UN-BUNDLED SERVICE VS BUNDLED SERVICE
				E&M SERVICE NOT REIMBURSED SEPARATELY
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.	N390	This service/report cannot be billed separately.	INJECTION PART OF ASPIRATION
97	The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.			ASPIRATION/INJCTN CONFLICT
				SERVICE IS COVERED IN DHS DAILY RATE
				BUNDLED PROCEDURE/HISTORY OF PAID CLAIM
				EMER EXAM/OTHER SERV SAME DOS
				PD OUTPT CLAIM CONFLICT
				COG SERV IS IN PACKAGE PROC
				PROC COMBINATION NOT EXPECTED SAME DAY
				PROC COMBO NOT EXPTD SAME DAY,PD CLM HIS
				PAYMENT INC W/ DENTAL PACKAGE PROCEDURE
				PAYMENT INC W/DENTL PKG PROC,PD CLM HIST
				DENTL EXAM INC W PAYMENT OF ANOTHER CODE
				DENTL EXAM IN W PAYMENT OF PD CLM HIST
				DENTL PROC COMBO NOT EXPECTED SAME DAY
				D PROC COMBO NOT EXP SAME DAY,PD CLM HIS
				CURRNT PROC MUTUAL EXCLUSV TO HISTR PROC
				HIST PROC MUTUAL EXLUSV TO CURRENT PROC

N19 - Procedure code incidental to primary procedure.

Reason for denial:

Payer does not pay separately for this service

Some services/procedures are considered "always bundled". These services can never be separately
reimbursed.

To confirm whether the procedure billed is considered always bundled please refer to the carrier website or NCC Edits and check to see if the procedure has a status code of "B" or "P". If so it is always considered bundled and no additional reimbursement is paid by Medicare. Based on that we can call the carrier and argue to get paid.

Actions:

Confirm that you have billed the correct procedure code.
If the wrong code was originally submitted send a new claim.
If the correct code was used, write off the charges. Do not rebill the claim or bill the beneficiary.

- CPT codes: 36415, 80048, 80053, 80061, 83036, 84443, 85610 - CPT modifier 91 - To avoid duplicate denial

Clinical Laboratory Procedures: Duplicate Denials - CO18

Denial Reason, Reason/Remark Code(s)

• CO-18 - Duplicate Service(s): Same service submitted for the same patient

• CPT codes: 36415, 80048, 80053, 80061, 83036, 84443, 85610

Basic Metabolic Panel (Calcium, total), 80048 

80053 Comprehensive Metabolic Panel Includes the following component code:
 

Resolution/Resources

First: Verify the status of your claim before resubmitting. Use the Online Provider Services (OPS) tool or call the Interactive Voice Response unit (IVR).

• All providers that have an EDI Enrollment Agreement on file may register to use this tool. If you haven’t already registered, please consider doing so.

• Access the introductory article to learn more: click on the 'Introducing Online Provider Services' graphic on the top of any of our main state Web pages

• One important consideration: only one Provider Administrator per EDI Enrollment Agreement/per PTAN/NPI combination performs the registration process. The Provider Administrator can then grant permission to additional users related to that PTAN/NPI.

• Billing services and clearinghouses should contact their provider clients to gain access to the system

• Specific instructions for accessing claim status information through OPS are available in the OPS User Manual

CPT modifier 91 may be submitted to identify an identical laboratory test for the same patient on the same date.

• This modifier may not be submitted when tests are rerun to confirm initial results due to testing problems with specimens or equipment, or for any other reason when a normal, one-time, reportable result is all that is required

• This modifier may not be used when other codes describe a series of test results (e.g., glucose tolerance tests)

• For clinical laboratory tests ordered by an ESRD facility: these tests must be submitted with CPT modifier 91 if any single service (same CPT code) is ordered for the same patient, and the specimen is collected more than once in a single day, and the service is medically necessary

o CPT modifier 91 must be submitted with services that meet these criteria, regardless of whether the test is also submitted with HCPCS modifiers CD, CE or EF

o Any line item on a claim that meets these criteria and is submitted with CPT modifier 91 will be included into the calculation of the 50/50 rule

o After calculation of the 50/50 rule, services used to determine the payment amount may not exceed 22



Laboratory Panels

Individual laboratory codes, which together make up a laboratory Panel Code, will be denied. The provider will be required to submit the more comprehensive laboratory Panel Code as described under the specific laboratory panel headings below. Organ or Disease-Oriented Laboratory Panel Codes

The Organ or Disease-Oriented Panels as defined in the CPT book are codes 80047, 80048, 80050, 80051, 80053, 80055, 80061, 80069, 80074, and 80076. According to the CPT book, these panels were developed for coding purposes only and are not to be interpreted as clinical parameters. UnitedHealthcare Community Plan uses CPT coding guidelines to define the components of each panel.

UnitedHealthcare Community Plan also considers an individual component code included in the more comprehensive Panel Code when reported on the same date of service by the Same Individual Physician or Other Health Care Professional. The Professional Edition of the CPT ® book, Organ or DiseaseOriented Panel section states: "Do not report two or more panel codes that include any of the same constituent tests performed from the same patient collection. If a group of tests overlaps two or more panels, report the panel that incorporates the greater number of tests to fulfill the code definition and report the remaining tests using individual test codes."

For reimbursement purposes, UnitedHealthcare Community Plan differs from the CPT book's inclusion of the specific number of Component Codes within an Organ or Disease-Oriented Panel. UnitedHealthcare Community Plan will deny the individual Component Codes and require the provider to submit the more comprehensive Panel Code. as set forth more fully in the tables below. The tables for CPT codes 80047, 80048, 80050, 80051, 80053, 80061, 80069, 80074 and 80076 identify the Component Codes that UnitedHealthcare Community Plan will require the submission of the specific panel.

Basic Metabolic Panel (Calcium, total), 80048

CPT coding guidelines indicate that a Basic Metabolic Panel (Calcium, total), CPT code 80048 should not be reported in conjunction with 80053. If a submission includes CPT 80048 and CPT 80053, only CPT 80053 will be reimbursed. There are 2 configurations for a Basic Metabolic Panel (Calcium, total), CPT code 80048:

1. A submission that includes 5 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, total), CPT code 80048.

Panel Code Component Code Code Description

80048 Basic Metabolic Panel (Calcium, total), 80048 Must contain 5 or more of the following Component Codes for the same patient on the same date of service

82310 Calcium; total
82374 Carbon Dioxide (bicarbonate)
82435 Chloride; blood
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84132 Potassium; serum, plasma or whole blood
84295 Sodium; serum, plasma or whole blood
84520 Urea nitrogen (BUN)

2. A submission that includes an Electrolyte Panel, CPT code 80051 plus 1 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, total) CPT code 80048.

Panel Code Component Code Code Description

80048 Basic Metabolic Panel (Calcium, total), 80048

Includes the following panel: 80051 Electrolyte Panel.

Plus 1 or more of the following Component Codes for the same patient on the same date of service:
82310 Calcium; total
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)

84520 Urea nitrogen (BUN)A submission that includes a Basic Metabolic Panel (Calcium, total), CPT code 80048, and 2 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Comprehensive Metabolic Panel, CPT code 80053.

Panel Code Component Code Code Description

80053 Comprehensive Metabolic Panel Includes the following panel:
80048 Basic Metabolic Panel (Calcium, total) Plus 2 or more of the following Component Codes for the same patient on the same date of service:
82040 Albumin; serum, plasma or whole blood
82247 Bilirubin; total
84075 Phosphatase, alkaline
84155 Protein, total
84450 Transferase, aspartate amino (AST) (SGOT)
84460 Transferase; alanine amino (ALT) (SGPT)

3. A submission that includes an Electrolyte Panel, CPT code 80051, and 6 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Comprehensive Metabolic Panel, CPT code 80053.

Panel Code Component

Code Code Description 80053 Comprehensive Metabolic Panel

Includes the following panel:
80051 Electrolyte Panel Plus 6 or more of the following Component Codes for the same patient on the same date of service:
82040 Albumin; serum, plasma or whole blood
82247 Bilirubin; total
82310 Calcium; total
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84075 Phosphatase, alkaline
84155 Protein, total, except by refractometry; serum, plasma or whole blood
84450 Transferase, aspartate amino (AST) (SGOT)
84460 Transferase; alanine amino (ALT) (SGPT)
84520 Urea nitrogen (BUN) When the Same Individual Physician or Other Health Care Professional reports CPT 80053 with CPT
80048 or CPT 80076 for the same patient on the same date of service, neither CPT 80048 nor CPT
80076 will be reimbursed separately.

CPT Panel Code 80053 includes all of the components of CPT Panel Code 80048 and all the components of CPT Panel Code 80076, except for CPT 82248 (bilirubin, direct). Therefore, when performed with all of the components of CPT 80053, report CPT 82248 separately. Obstetric Panel, 80055

A submission that includes one of the following CBC or combination of CBC Component Codes, either CPT codes 85025 or 85027 + 85004 or CPT codes 85027 + 85007 or 85027 + 85009 and each component CPT code Syphilis, non-treponemal antibody 86592, Antibody, Rubella, 86762, RBC antibody screen, 86850, Blood typing ABO, 86900, Blood typing RH (D), 86901 and Hepatitis B surface antigen (HBsAg), 87340 by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as an Obstetric Panel, CPT code 80055.

NOTE: The Hepatitis B Surface Antigen (87340) is a component code of both the Obstetric Panel (80055) and the Acute Hepatitis Panel (80074). The Obstetric Panel takes Precedence.

NOTE: Renal Function Panel, 80069, includes the Basic Metabolic Panel, CPT code 80048, submitted by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service.

Panel Code Component Code Code Description 80069 Renal Function Panel 

Includes 6 or more of the following Component Codes for the same patient
on the same date of service:
82040 Albumin; serum, plasma or whole blood
82310 Calcium; total
82374 Carbon dioxide (bicarbonate)
82435 Chloride; blood
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84100 Phosphorus inorganic (phosphate)
84132 Potassium; serum, plasma or whole blood
84295 Sodium; serum, plasma or whole blood
84520 Urea nitrogen (BUN)

Acute Hepatitis Panel, 80074

A submission that includes all of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as an Acute Hepatitis Panel, CPT code 80074.

NOTE: Hepatitis B Surface Antigen (87340) is a Component Code for both the Obstetric Panel, CPT code 80055, and the Acute Hepatitis Panel, CPT code 80074. The Obstetric Panel, CPT code 80055, takes Precedence.

Panel Code Component Code Code Description

80074 Acute Hepatitis Panel

Includes all of the following Component Codes for the same patient on the same date of service:
86705 Hepatitis B core antibody IgM (HBcAb)
86709 Hepatitis A antibody (HAAb), IgM
86803 Hepatitis C antibody
87340 Hepatitis B surface antigen (HBsAg)




Guideline from UHC insurance

Organ or Disease-Oriented Laboratory Panel Codes

The Organ or Disease-Oriented Panels as defined in the CPT book are codes 80047, 80048, 80050, 80051, 80053, 80055, 80061, 80069, 80074, and 80076. According to the CPT book, these panels were developed for coding purposes only and are not to be interpreted as clinical parameters. UnitedHealthcare Community Plan uses CPT coding guidelines to define the components of each panel.

UnitedHealthcare Community Plan also considers an individual component code included in the morecomprehensive Panel Code when reported on the same date of service by the Same Individual Physician or Other Health Care Professional. The Professional Edition of the CPT ® book, Organ or DiseaseOriented Panel section states: "Do not report two or more panel codes that include any of the same constituent tests performed from the same patient collection. If a group of tests overlaps two or more panels, report the panel that incorporates the greater number of tests to fulfill the code definition and report the remaining tests using individual test codes."

For reimbursement purposes, UnitedHealthcare Community Plan differs from the CPT book's inclusion of the specific number of Component Codes within an Organ or Disease-Oriented Panel. UnitedHealthcare Community Plan will deny the individual Component Codes and require the provider to submit the more comprehensive Panel Code. as set forth more fully in the tables below. The tables for CPT codes 80047, 80048, 80050, 80051, 80053, 80061, 80069, 80074 and 80076 identify the Component Codes that UnitedHealthcare Community Plan will require the submission of the specific panel.

Basic Metabolic Panel (Calcium, ionized), 80047

CPT coding guidelines indicate that a Basic Metabolic Panel (Calcium, ionized), CPT code 80047 should not be reported in conjunction with CPT code 80053. If a submission includes CPT 80047 and CPT 80053, both codes will be denied; the services will need to be resubmitted with CPT 80053 to be reimbursed.

There are 2 configurations for a Basic Metabolic Panel, CPT code 80047:

1. A submission that includes CPT code 82330 plus 4 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, ionized), CPT code 80047.

Panel Code Component

Code Code Description 80047 Basic Metabolic Panel (Calcium, ionized), 80047

Includes the following: 82330 Calcium; ionized

Plus 4 or more of the following Component Codes for the same patient on the same date of service:

82374 Carbon Dioxide (bicarbonate)
82435 Chloride; blood
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84132 Potassium; serum, plasma or whole blood
84295 Sodium; serum, plasma or whole blood
84520 Urea nitrogen (BUN)

2. A submission that includes an Electrolyte Panel, CPT code 80051 plus 1 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, ionized) CPT code 80047.

Panel Code Component

Code Code Description 80047 Basic Metabolic Panel (Calcium, ionized), 80047

Includes the following panel:
80051 Electrolyte Panel Plus the following component code:
82330 Calcium; ionized Plus at least one of the following Component Codes for the same patient on the same date of service:
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84520 Urea nitrogen (BUN)

Basic Metabolic Panel (Calcium, total), 80048

CPT coding guidelines indicate that a Basic Metabolic Panel (Calcium, total), CPT code 80048 should not be reported in conjunction with 80053. If a submission includes CPT 80048 and CPT 80053, only CPT 80053 will be reimbursed. There are 2 configurations for a Basic Metabolic Panel (Calcium, total), CPT code 80048:

1. A submission that includes 5 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, total), CPT code 80048.

Panel Code Component Code Code Description

80048 Basic Metabolic Panel (Calcium, total), 80048 Must contain 5 or more of the following Component Codes for the same patient on the same date of service
82310 Calcium; total
82374 Carbon Dioxide (bicarbonate)
82435 Chloride; blood
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84132 Potassium; serum, plasma or whole blood
84295 Sodium; serum, plasma or whole blood
84520 Urea nitrogen (BUN)

2. A submission that includes an Electrolyte Panel, CPT code 80051 plus 1 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Basic Metabolic Panel (Calcium, total) CPT code 80048.

Panel Code Component

Code Code Description 80048 Basic Metabolic Panel (Calcium, total), 80048

Includes the following panel:
80051 Electrolyte Panel
.
Plus 1 or more of the following Component Codes for the same patient on the same date of service:

82310 Calcium; total
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84520 Urea nitrogen (BUN)

Hormone, CPT code 84443 and one of the following CBC or combination of CBC Component Codes, either CPT codes 85025 or 85027 + 85004 or 85027 + 85007 or 85025 + 85009 by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a General Health Panel, CPT code 80050.

Panel Code Component

Code Code Description

80050 General Health Panel Includes the following panel:

80053 Comprehensive Metabolic Panel Includes the following component code:

84443 Thyroid Stimulating Hormone (TSH) Plus one of the following CBC or combination of CBC Component Codes for the same patient on the same date of service:

85025 Blood Count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count 85027 +

85004 Blood Count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) AND

Blood count; automated differential WBC count 85027 + 85007

Blood Count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) AND Blood count; blood smear, microscopic examination with manual differential WBC count 85027 +

85009 Blood Count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) AND

Blood count; manual differential WBC count, buffy coat When Hepatic Function Panel code 80076 is submitted on the same date of service by the Same Individual Physician or Other Health Care Professional for the same patient as General Health Panel code 80050, CPT code 80076 will not be separately reimbursed.

Comprehensive Metabolic Panel code 80053, a component of Panel Code 80050, includes all components of Hepatic Function Code 80076 except for code 82248 (bilirubin, direct).

Comprehensive Metabolic Panel, 80053

There are 3 configurations for a Comprehensive Metabolic Panel, CPT code 80053:

1. A submission that includes 10 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Comprehensive Metabolic Panel, CPT code 80053.

Panel Code Component Code Code Description

80053 Comprehensive Metabolic Panel Must contain 10 or more of the following Component Codes for the same patient on the same date of service:
82040 Albumin; serum, plasma or whole blood
82247 Bilirubin; total
82310 Calcium; total
82374 Carbon dioxide (bicarbonate)
82435 Chloride; blood
82565 Creatinine; blood
82947 Glucose quantitative, blood (except reagent strip)
84075 Phosphatase, alkaline
84132 Potassium; serum, plasma or whole blood
84155 Protein, total, except by refractometry; serum, plasma or whole blood
84295 Sodium; serum, plasma or whole blood
84450 Transferase, aspartate amino (AST) (SGOT)
84460 Transferase, alanine amino (ALT) (SGPT)
84520 Urea Nitrogen (BUN)

2. A submission that includes a Basic Metabolic Panel (Calcium, total), CPT code 80048, and 2 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Comprehensive Metabolic Panel, CPT code 80053.

Panel Code Component

Code Code Description

80053 Comprehensive Metabolic Panel Includes the following panel:
80048 Basic Metabolic Panel (Calcium, total) Plus 2 or more of the following Component Codes for the same patient on the same date of service:
82040 Albumin; serum, plasma or whole blood
82247 Bilirubin; total
84075 Phosphatase, alkaline
84155 Protein, total
84450 Transferase, aspartate amino (AST) (SGOT)
84460 Transferase; alanine amino (ALT) (SGPT)

3. A submission that includes an Electrolyte Panel, CPT code 80051, and 6 or more of the following laboratory Component Codes by the Same Individual Physician or Other Health Care Professional for the same patient on the same date of service is a reimbursable service as a Comprehensive Metabolic Panel,

CPT code 80053.

Panel Code Component Code Code Description

80053 Comprehensive Metabolic Panel Includes the following panel:
80051 Electrolyte Panel Plus 6 or more of the following Component Codes for the same patient on the same date of service:
82040 Albumin; serum, plasma or whole blood
82247 Bilirubin; total
82310 Calcium; total
82565 Creatinine; blood
82947 Glucose; quantitative, blood (except reagent strip)
84075 Phosphatase, alkaline
84155 Protein, total, except by refractometry; serum, plasma or whole blood
84450 Transferase, aspartate amino (AST) (SGOT)
84460 Transferase; alanine amino (ALT) (SGPT)
84520 Urea nitrogen (BUN) When the Same Individual Physician or Other Health Care Professional reports CPT 80053 with CPT
80048 or CPT 80076 for the same patient on the same date of service, neither CPT 80048 nor CPT
80076 will be reimbursed separately.

CPT Panel Code 80053 includes all of the components of CPT Panel Code 80048 and all the components of CPT Panel Code 80076, except for CPT 82248 (bilirubin, direct). Therefore, when performed with all of the components of CPT 80053, report CPT 82248 separately.

Obstetric Panel, 80055

A submission that includes one of the following CBC or combination of CBC Component Codes, either CPT codes 85025 or 85027 + 85004 or CPT codes 85027 + 85007 or 85027 + 85009 and each component CPT code Syphilis, non-treponemal antibody 86592, Antibody, Rubella, 86762, RBC antibody screen, 86850, Blood typing ABO, 86900, Blood typing RH (D), 86901 and Hepatitis B surface antigen (HBsAg), 87340 by the Same Individual Physician or Other Health Care Professional for the same patient  on the same date of service is a reimbursable service as an Obstetric Panel, CPT code 80055. NOTE: The Hepatitis B Surface Antigen (87340) is a component code of both the Obstetric Panel (80055) and the Acute Hepatitis Panel (80074). The Obstetric Panel takes Precedence.

Panel Code Component

Code Code Description  80055 Obstetric Panel

Includes one of the following CBC or combination of CBC Component Codes for the same patient on the same date of service:

85025 Blood Count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count

85027 + 85004 Blood count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) Hemogram and platelet count, automated complete differential WBC count (CBC) AND Blood count; automated differential WBC count

85027 + 85007 Blood count; complete (CBC) automated (Hgb, Hct, RBC, WBC and  platelet count) Hemogram and platelet count, automated complete differential WBC count (CBC) AND Blood count; blood smear, microscopic examination with manual differential WBC count

85027 + 85009 Blood count; complete (CBC) automated (Hgb, Hct, RBC, WBC and platelet count) Hemogram and platelet count, automated complete differential WBC count (CBC) AND Blood count; manual differential WBC count, buffy coat

Exceptions Delaware Delaware allows H0048 behavioral health code

Iowa Iowa providers are allowed to bill 99000 for lab services. Kansas Per Kansas State Regulations codes 84443, 85025, and 80053 can be billed separately and should not be denied into panel code 80050. Maryland Maryland allows payment of CPT 36416 when billed with an Evaluation and Management service.

Michigan Michigan follows CPT direction regarding panel codes and requires all components of a panel to be submitted; these codes will be denied and will need to be resubmitted with the corresponding panel code.

New Mexico Per New Mexico Medicaid State Regulations Drug Assay CPT codes 80320-80377 are considered non-reimbursable. These services may be reported under an appropriate HCPCS code.

Ohio Ohio follows CPT direction regarding panel codes and requires all components of a panel to be submitted; these codes will be denied and will need to be resubmitted with the corresponding panel code. Ohio allows payment of CPT 36416 when billed with an Evaluation and Management service.

Per state requirements, Ohio Medicaid and MME plans require that certain lab codes cannot be submitted with a modifier. The list of codes is included in the policy. Ohio allows code H0048 under their Redesign product for lab services. Texas Texas allows reimbursement for CPT code 99000. Wisconsin Wisconsin allows payment of CPT 36416 when billed with an Evaluation and Management service for members ages 6 and under. Wisconsin allows reimbursement for CPT code 99000 & 99001.
 

CPT code 82947, 85610 Guide - Does required CLIA?

procedure   Code Description


85610   Prothrombin time


CMS (Medicare) has determined that Prothrombin Time (procedure Code 85610) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a diagnostic condition other than those listed below, please have your patient sign and date an Advanced Beneficiary Notice (ABN). All ICD-9-CM codes provided must be consistent with the documentation in the patient’s medical records for the date of service. 


NOTE: Please be aware that it is not enough to link the procedure code to a correct, payable ICD-9-CM diagnosis code. The diagnosis must be present for the procedure to be paid. In addition, the procedure must be reasonable and necessary for that diagnosis. Documentation within the beneficiary's medical record must support the necessity for the test(s) provided for each date of service. For additional information, see the “Limited Coverage Guidebook Information” provided in this section.


Note: Since the INR is a calculation, it will not be paid separately from or in addition to the PT, but is considered part of the conventional prothrombin time, 85610. 

Description

Basic plasma coagulation function is readily assessed with a few simple laboratory tests: the Partial Thromboplastin Time (PTT), Prothrombin Time (PT), Thrombin Time (TT), or a quantitative fibrinogen determination. The PT test is one in-vitro laboratory test used to assess coagulation. While the PTT assesses the intrinsic limb of the coagulation system, the PT assesses the extrinsic or tissue factor dependent pathway. Both tests also evaluate the common coagulation pathway involving all the reactions that occur after the activation of factor X. Extrinsic pathway factors are produced in the liver and their production is dependent on adequate vitamin K activity. Deficiencies of factors may be related to decreased production or increased consumption of coagulation factors. The PT/INR is most commonly used to measure
the effect of warfarin and regulate its dosing. Warfarin blocks the effect of vitamin K on hepatic production of extrinsic pathway factors.



A PT is expressed in seconds and/or as an international normalized ratio (INR). The INR is the PT ratio that would result if the WHO reference thromboplastin was used in performing the test. Current medical information does not clarify the role of laboratory PT testing in patients who are self monitoring. Therefore, the indications for testing apply regardless of whether or not the patient is also PT self-testing.

PROTHROMBIN TIME (PT) (procedure 85610)

ICD-10 Description ICD-10 ICD-9

Abnormal Coagulation Profile R79.1 790.92

Atherosclerotic Heart Disease of Native Coronary Artery without Angina

Pectoris I25.10 414

Encounter for Therapeutic Drug Level Monitoring Z51.81 V58.83

Heart Failure, Unspecified I50.9 428

Long-Term (Current) Use of Anticoagulants Z79.01 V58.61

Nutritional Anemia, Unspecified D53.9 281.9

Unspecified Atrial Fibrillation I48.91 427.31


UnitedHealthcare Community Plan reimburses for Prothrombin Time (procedure code 85610), when the claim indicates a code found on the list of approved diagnosis codes for this test. UnitedHealthcare Community Plan will not reimburse when the treatment rendered is without inclusion of one of the ICD-9-CM and ICD- 10CM diagnostic codes being included on the claim accurately reflecting the member's condition.


Modifiers are often added to a procedure code to provide further information about a service provided. The QW modifier indicates that the laboratory test performed was CLIA-waived. 

The QW modifier is generally required on Medicare reimbursement claims when performing CLIA-waived tests.

What is the payment amount for PT/INR testing in those instances in which Medicare coverage in available?

Medicare payment will be based on the Part B Clinical Laboratory Fee Schedule amount. In 2016, the Medicare NLA for PT/INR testing (85610) is $5.36. See page 11 for the 2016 payment amount for specific states.

A nurse in a physician’s office performs a PT/INR test as ordered by the treating physician with a CoaguChek XS System for Professional Use. During the encounter, the nurse briefly examines the patient and observes that the patient has a number of bruises. The PT/INR result is outside of the target range for the patient. On brief history, the patient advises the nurse that he has changed his diet recently and has reduced his intake of green leafy vegetables. The nurse reviews the necessary dietary restrictions and treatment regimen with the patient, discusses necessary changes in warfarin dosing, and documents the discussion and the provision of these services in the patient’s medical record. The treating physician, who is on site but does not see the patient, is supervising the nurse and agrees with the recommended changes in the patient’s course of treatment.

In addition to reporting the PT/INR test—CPT code 85610—the physician may be able to bill for the incident to E/M services provided by the nurse, as long as the E/M services were medically necessary. Only one E/M code may be billed for a visit. Because the nurse is a nonphysician employee  as specified by Medicare, the low level E/M code, 99211, if substantiated, may be appropriate to report. Only one E/M code may be billed for a visit.

CLIA: Laboratory Tests related denials - CO-B7


Denial Reason, Reason/Remark Code(s):

• CO-B7: This provider was not certified/eligible to be paid for this procedure/service on this date of service

• procedure codes include: 82947 and 85610

Resolution

• HCPCS modifier QW must be submitted with certain clinical laboratory tests that are waived from the Clinical Laboratory Improvement Amendments of 1988 (CLIA) list. The Food and Drug Administration (FDA) determines which laboratory tests are waived.

• Note: Not all CLIA-waived tests require HCPCS modifier QW

• Determine if the CPT code is a waived test by accessing the CMS CLIA Web page

• Palmetto GBA will publish information on tests newly classified as 'waived' on our Web site. Please note, the list of CLIA-waived procedures is updated as often as quarterly.

• The CLIA certificate number is also required on claims for CLIA waived tests. Submit this information in Loop 2300 or 2400, REF/X4, 02 for electronic claims. For paper claims, submit the CLIA certification number in Item 23 of the CMS-1500 claim form.

• Access complete instructions for correctly submitting HCPCS modifier QW in the Palmetto GBA Modifier Lookup tool:

o Jurisdiction 1: Select 'Articles' on the left side of the Palmetto GBA Web page

o Ohio, South Carolina and West Virginia: Select 'Browse by Topic' on the left side of the Palmetto GBA Web page


85610 Prothombintime

85610QW April 15, 2010 CoaguSense Self-Test Prothrombin Time/INR  Monitoring System (Prescription Home Use) 

CMS (Medicare) has determined that Prothrombin Time (CPT Code 85610) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a diagnostic condition other than those listed below, please have your patient sign and date an Advanced Beneficiary Notice (ABN). All ICD-9-CM codes provided must be consistent with the documentation in the patient’s medical records for the date of service.

NOTE: Please be aware that it is not enough to link the procedure code to a correct, payable ICD-9-CM diagnosis code. The diagnosis must be present for the procedure to be paid. In addition, the procedure must be reasonable and necessary for that diagnosis. Documentation within the beneficiary's medical record must support the necessity for the test(s) provided for each date of service. For additional information, see the “Limited Coverage Guidebook Information” provided in this section.


Note: Since the INR is a calculation, it will not be paid separately from or in addition to the PT, but is considered part of the conventional prothrombin time, 85610. 


Modifier QW

Description CLIA-waived test

The QW modifier is generally required on Medicare reimbursement claims when performing CLIA-waived tests.


Laboratories with a CLIA certificate of waiver are permitted to perform only CLIA-waived tests. May a provider bill an additional code for obtaining a blood sample by means of capillary (finger, heel ear) access?No. Medicare does not reimburse for finger stick specimen collection. Note: Medicare does reimburse for venous blood sample access, when necessary and appropriate.
Scenario B

A nurse in a physician’s office performs a PT/INR test as ordered by the treating physician with a CoaguChek XS System for Professional Use. During the encounter, the nurse briefly examines the patient and observes that the patient has a number of bruises. The PT/INR result is outside of the target range for the patient. On brief history, the patient advises the nurse that he has changed his diet recently and has reduced his intake of green leafy vegetables. The nurse reviews the necessary dietary restrictions and treatment regimen with the patient, discusses necessary changes in warfarin dosing, and documents the discussion and the provision of these services in the patient’s medical record. The treating physician, who is on site but does not see the patient, is supervising the nurse and agrees with the recommended changes in the patient’s course of treatment.

In addition to reporting the PT/INR test—CPT code 85610—the physician may be able to bill for the incident to E/M services provided by the nurse, as long as the E/M services were medically necessary. Only one E/M code may be billed for a visit. Because the nurse is a nonphysician employee as specified by Medicare, the low level E/M code, 99211, if substantiated, may be appropriate to report. Only one E/M code may be billed for a visit.

This scenario applies to any nonphysician employee of the physician, working within the scope of practice allowed in their state. Medically necessary PT/ INR testing and significant, separately identifiable and medically necessary face-to-face E/M services are eligible for reimbursement under Medicare.
Contrast this with the previous scenario, in which staff members had to receive the results, assess the risk factors, review the results and treatment regimen with the treating physician, call the patient to report the results and any change of regimen, and document and review the additional complaints presented during the phone call with the treating physician--all with no potential for additional reimbursement because the requirements to report a separately, identifiable E/M service were not met.




CPT CODE(S) TEST NAME MANUFACTURER USE 85018QW

4. Clarity HbCheck Hemoglobin Testing System Acon Laboratories, Inc. Measures hemoglobin level in whole blood
5. HemoCue Donor Hemoglobin Checker System HemoCue HemoCue, Inc.
6. HemoCue Hemoglobin System HemoCue, Inc.
7. HemoCue Hemoglobin 201+ (Capillary, Venous, Arterial Whole Blood) HemoCue, Inc.
8. HemoCue Hemoglobin 201+/HemoCue Hemoglobin Microcuvette System HemoCue, Inc.
9. HemoCue Hb 301 System HemoCue, Inc.
10. GDS Diagnostics HemoSite Meter - for hemoglobin GDS Technology, Inc.
11. GDS Technology STAT-Site MHgb Test System

GDS Technology

85576QW Accumetrics VerifyNow Aspirin Assay Accumetrics Inc. Qualitative assay to measure platelet aggregation
85610QW (Contact your Medicare carrier for claims instructions.)

1. AlereINRatio®2 PT/INR Home Monitoring System {Prescription Home Use} Alere San Diego, Inc. Aid in screening for congenital deficiencies of Factors II, V, VII, X; screen for deficiency of prothrombin; evaluate heparin effect, coumadin or warfarin effect; screen for Vitamin K deficiency
2. AvoSure PT System (prescription home use) Avocet Medical, Inc.
3. AvoSure Pro (professional use) Avocet Medical, Inc.
4. CoaguChek PST for Prothrombin Time Boehringer Mannheim Corporation
5. Coag-Sense Prothrombin Time (PT/INR) Monitoring system (Professional use) CoaguSense, Inc. 85610QW (cont.) (Contact your Medicare carrier for claims instructions.)
6. CoaguSense Self-Test Prothrombin Time/INR Monitoring System (Prescription Home Use) CoaguSense, Inc. Aid in screening for congenital deficiencies of Factors II, V, VII, X; screen for deficiency of prothrombin; evaluate heparin effect, coumadin or warfarin effect; screen for Vitamin K deficiency
7. HemoSense INRatio System HemoSense, Inc.
8. ITC Protime Microcoagulation System for Prothrombin Time International Technidyne Corporation (ITC)
9. International Technidyne ProTime Microcoagulation System (ProTime 3 Cuvette) Prescription Home Use International Technidyne Corporation
10. International Technidyne ProTime Microcoagulation System (ProTime 3 Cuvette) Professional Use International Technidyne Corporation
11. Lifescan Harmony? INR Monitoring System -- Prescription Home Use and Professional Use Lifescan, Inc.
12. Roche/Boehringer Mannheim CoaguChek System for Professional Use Roche Diagnostics/ Boehringer Mannheim Corporation
13. Roche Diagnostics Coaguchek PST Roche Diagnostics
14. Roche Diagnostics Coagu Chek S Systems Test (for prothrombin time) Roche Diagnostics
15. Roche Diagnostics CoaguChek XS Roche Diagnostics
16. Roche Diagnostics CoaguChek XS