Prothrombin Time (PT)

Transcription

1 Previously Listed as Edit 6 Other Names/Abbreviations PT Prothrombin Time (PT) 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. HCPCS s (Alphanumeric, CPT AMA) Prothrombin Time ICD-9-CM s Covered by Medicare Program The individual ICD-9-CM codes included in code ranges in the table below can be viewed on CMS website under Downloads: Lab List. The link is: :// Typhoid and paratyphoid Other Salmonella infections Unspecified Septicemia 042 Human Immunodeficiency virus (HIV) disease Yellow fever Arthropod-borne hemorrhagic fever Viral hepatitis 075 Infectious mononucleosis Fu Associates, Ltd. 50 January 2013

2 078.6 Hemorrhagic nephrosonephritis Arenaviral hemorrhagic fever Blackwater fever Schistosomiasis Clonorchiasis Fascioliasis 124 Trichinosis Hirudiniasis 135 Sarcoidosis Malignant neoplasm of small intestine, including duodenum Malignant neoplasm of liver and intrahepatic bile ducts Malignant neoplasm of gallbladder and extrahepatic bile ducts Malignant neoplasm of pancreas Malignant neoplasm of bladder, kidney, and other and unspecified urinary organs Secondary malignant neoplasm, liver Secondary malignant neoplasm, kidney Secondary malignant neoplasm, other urinary organs Lymphosarcoma and reticulosarcoma; Burkitt s tumor or lymphoma Marginal zone lymphoma Mantle cell lymphoma Primary central nervous system lymphoma Anaplastic large cell lymphoma Large cell lymphoma Malignant tumors of lymphatic tissue; other named variants Other malignant neoplasms of lymphoid and histiocytic tissue Peripheral T-cell lymphoma Other lymphomas; other and unspecified malignant neoplasms of lymphoid and histiocytic tissue , Malignant carcinoid tumors of other and unspecified sites Secondary neuroendocrine tumor, unspecified site Secondary neuroendocrine tumor of distant lymph nodes Secondary neuroendocrine tumor of liver Secondary neuroendocrine tumor of bone Secondary neuroendocrine tumor of peritoneum Secondary Merkel cell carcinoma Secondary neuroendocrine tumor of other sites Benign neoplasm of kidney and other urinary organs Polycythemia vera Histocytic and mast cells neoplasm of uncertain behavior Plasma cells neoplasm of uncertain behavior Essential thrombocythemia Fu Associates, Ltd. 51 January 2013

3 Low grade myelodysplastic syndrome lesions High grade myelodysplastic syndrome lesions Myelodysplastic syndrome with 5q deletion Myelodysplastic syndrome, unspecified Myelofibrosis with myeloid metaplasia Post-transplant lymphoproliferative disorder (PTLD) Other lymphatic and hematopoietic tissues Neoplasm of unspecified nature, bladder Neoplasm of unspecified nature, other genitourinary organs Neoplasm of unspecified nature, site unspecified Hemorrhage and infarction of thyroid Secondary diabetes mellitus with renal manifestations, not stated as uncontrolled Secondary diabetes mellitus with renal manifestations, uncontrolled Diabetic with renal manifestations Other and unspecified protein/calorie malnutrition Deficiency of Vitamin K Unspecified vitamin deficiency , Disorders of plasma protein metabolism Hereditary hemochromatosis Hemochromatosis due to repeated red blood cell transfusions Other hemochromatosis Other disorders of iron metabolism Disorders of porphyrin metabolism Amyloidosis, unspecified Familial Mediterranean fever Other amyloidosis Iron deficiency anemia, secondary to blood loss - chronic Iron deficiency anemia, unspecified Pernicious anemia Other vitamin B12 deficiency anemia, NEC Unspecified deficiency anemia, NOS Sideroblastic anemia Acute posthemorrhagic anemia Coagulation defects Allergic purpura; qualitative platelet defects; other nonthrombocytopenic purpuras; primary thrombocytopenia Posttransfusion purpura Other secondary thrombocytopenia Thrombocytopenia, unspecified; other specified and unspecified hemorrhagic conditions Fu Associates, Ltd. 52 January 2013

4 Primary hypercoagulable state Vascular dementia 325 Phlebitis and thrombophlebitis of intracranial venous sinuses Hemiplegia NOS Hemophthalmos, except current injury Retinal vasculitis Retinal vascular occlusion Hemorrhagic detachment of retinal pigment epithelium Retinal hemorrhage Choroidal hemorrhage and rupture, detachment Unspecified visual disturbances Conjunctival hemorrhage Hemorrhage of eyelid Orbital hemorrhage Hemorrhage in optic nerve sheaths Disorders of optic chiasm associated with vascular disorders Disorders of visual pathways associated with vascular disorders Disorders of visual cortex associated with vascular disorders Vitreous hemorrhage Hematoma of auricle or pinna Vertigo of central origin Labyrinthine dysfunction, unspecified Diseases of the mitral valve Rheumatic aortic stenosis Rheumatic aortic stenosis with insufficiency Diseases of mitral and aortic valves Diseases of other endocardial structures Other rheumatic heart disease , , Hypertensive chronic kidney disease, with chronic kidney disease stage V or end stage renal disease , , Hypertensive heart and chronic kidney disease, without heart failure and with chronic kidney disease stage V or end stage renal disease Acute myocardial infarction Intermediate coronary syndrome Coronary occlusion without myocardial infarction Other acute and subacute forms of ischemic heart disease Angina pectoris Coronary atherosclerosis Coronary atherosclerosis due to lipid rich plaque Coronary atherosclerosis due to calcified coronary lesion Other specified forms of chronic ischemic heart disease Fu Associates, Ltd. 53 January 2013

5 414.9 Chronic ischemic heart disease, unspecified Acute pulmonary heart disease Chronic pulmonary heart disease, unspecified Hemopericardium Mitral valve disorders Aortic valve disorder Endocarditis, valve unspecified, unspecified cause 425.0, , , Cardiomyopathy Cardiac dysrhythmias Heart failure Ill-defined descriptions and complications of heart disease Other sequelae of myocardial infarction, not elsewhere classified 430 Subarachnoid hemorrhage 431 Intracerebral hemorrhage Other and unspecified intracranial hemorrhage Occlusion and stenosis of precerebral arteries Occlusion of cerebral arteries Transient cerebral ischemia 436 Acute, but ill-defined cerebrovascular disease Cerebral atherosclerosis Other generalized ischemic cerebrovascular disease Nonpyogenic thrombosis of intracranial venous sinus Atherosclerosis of aorta; of other arteries; of bypass grafts Chronic total occlusion of artery of the extremities Atherosclerosis of other specified arteries; generalized and unspecified atherosclerosis Aortic aneurysm and dissection Other peripheral vascular disease , , Arterial embolism and thrombosis Stricture of artery Rupture of artery Arteritis, unspecified Hereditary hemorrhagic telangiectasia Other and unspecified capillary diseases Phlebitis and thrombophlebitis 452 Portal vein thrombosis Budd-Chiari syndrome Thrombophlebitis migrans Embolism and thrombosis of inferior vena cava Embolism and thrombosis of renal vein Fu Associates, Ltd. 54 January 2013

6 Acute venous embolism and thrombosis of unspecified deep vessels of lower extremity Acute venous embolism and thrombosis of deep vessels of proximal lower extremity Acute venous embolism and thrombosis of deep vessels of distal lower extremity Chronic venous embolism and thrombosis of unspecified deep vessels of lower extremity Chronic venous embolism and thrombosis of deep vessels of proximal lower extremity Chronic venous embolism and thrombosis of deep vessels of distal lower extremity Venous embolism and thrombosis of superficial vessels of lower extremity Chronic venous embolism and thrombosis of superficial veins of upper extremity Chronic venous embolism and thrombosis of deep veins of upper extremity Chronic venous embolism and thrombosis of upper extremity, unspecified Chronic venous embolism and thrombosis of axillary veins Chronic venous embolism and thrombosis of subclavian veins Chronic venous embolism and thrombosis of internal jugular veins Chronic venous embolism and thrombosis of other thoracic veins Chronic venous embolism and thrombosis of other specified veins Acute venous embolism and thrombosis of superficial veins of upper extremity Acute venous embolism and thrombosis of deep veins of upper extremity Acute venous embolism and thrombosis of upper extremity, unspecified Acute venous embolism and thrombosis of axillary veins Acute venous embolism and thrombosis of subclavian veins Acute venous embolism and thrombosis of internal jugular veins Acute venous embolism and thrombosis of other thoracic veins Acute venous embolism and thrombosis of other specified veins Other venous embolism and thrombosis of unspecified site Internal hemorrhoids with other complication External hemorrhoids with other complication Unspecified hemorrhoids with other complication Esophageal varices Varices of other sites Hemorrhage, unspecified Postphlebetic syndrome Fu Associates, Ltd. 55 January 2013

7 459.2 Compression of vein Venous (peripheral) insufficiency, unspecified Other, other specified disorders of circulatory system Malignant pleural effusion Other specified forms of effusion, except tuberculosis 514 Pulmonary congestion and hypostasis Gastroesophageal laceration - hemorrhage syndrome Esophageal hemorrhage Infection of esophagostomy Mechanical complication of esophagostomy Gastric ulcer, duodenal ulcer, peptic ulcer, gastrojejunal ulcer, gastritis and duodenitis Eosinophilic gastritis, without mention of obstruction Eosinophilic gastritis, with obstruction Regional enteritis Ulcerative colitis Vascular insufficiency of intestine Diverticulosis of small intestine with hemorrhage Diverticulosis of colon w/o hemorrhage Diverticulitis of colon w/o hemorrhage Diverticulosis of colon with hemorrhage Diverticulitis of colon with hemorrhage Hemoperitoneum (nontraumatic) Hemorrhage of rectum and anus Chronic liver disease and cirrhosis Hepatic encephalopathy Hepatorenal syndrome Other sequelae of chronic liver disease Hepatitis in viral diseases, other and unspecified disorder of liver Other disorders of Biliary tract Acute pancreatitis Gastrointestinal hemorrhage Intestinal Malabsorption Nephrotic Syndrome Nephritis, with unspecified pathological lesion in kidney Acute kidney failure with lesion of tubular necrosis Acute kidney failure with lesion of renal cortical necrosis Acute kidney failure with lesion of renal medullary (papillary) necrosis Acute kidney failure with other specified pathological lesion in kidney Acute kidney failure, unspecified Fu Associates, Ltd. 56 January 2013

8 Chronic kidney disease 586 Renal failure, unspecified Other specified disorders of kidney and ureter Hemorrhage into bladder wall Infection of cystostomy Mechanical complication of cystostomy Other complication of cystostomy Other specified disorders of bladder Hematuria, unspecified Gross hematuria Microscopic hematuria Vascular disorders of penis Vascular disorders of male genital organs Other specified disorders of breast including hematoma Hematoma of broad ligament Hematometra Other specified noninflammatory disorders of cervix Vaginal hematoma Other specified noninflammatory disorders of the vagina Hematoma of vulva Abnormal bleeding from female genital tract Premenopausal menorrhagia Postmenopausal bleeding Hematocele female, not classified elsewhere 632 Missed abortion Spontaneous abortion, complicated by excessive hemorrhage Legally induced abortion, complicated by delayed or excessive hemorrhage Illegally induced abortion, complicated by delayed or excessive hemorrhage Abortion unspecified, complicated by delayed or excessive hemorrhage Failed attempted abortion, complicated by delayed or excessive hemorrhage Delayed or excessive hemorrhage following abortion and ectopic and molar pregnancies Complications following abortion and ectopic and molar pregnancies with embolism Hemorrhage in early pregnancy Antepartum hemorrhage, abruptio placentae, and placenta previa Hypertension complicating pregnancy, childbirth, and the puerperium Liver disorders in pregnancy Fu Associates, Ltd. 57 January 2013

9 Coagulation defects complicating pregnancy, childbirth, or the puerperium, unspecified as to episode of care or not applicable Coagulation defects complicating pregnancy, childbirth, or the puerperium, delivered, with or without mention of antepartum condition Coagulation defects complicating pregnancy, childbirth, or the puerperium, delivered, with mention of postpartum complication Coagulation defects complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication Coagulation defects complicating pregnancy, childbirth, or the puerperium, postpartum condition or complication Spotting complicating pregnancy, unspecified as to episode of care or not applicable Spotting complicating pregnancy, delivered, with or without mention of antepartum condition Spotting complicating pregnancy, antepartum condition or complication Fetal maternal hemorrhage Infection of amniotic cavity Postpartum hemorrhage Venous complications in pregnancy and the puerperium except legs, vulva and perineum Obstetrical pulmonary embolism Other complications of obstetrical surgical wounds Arthropathy associated with hematological disorders Arthropathy associated with hypersensitivity reaction Hemarthrosis pelvic region and thigh Lower leg Multiple sites Pain in limb Swelling of limb Pathologic fracture, unspecified site Other Congenital anomalies of heart Other forms of placental separation and hemorrhage 767.0, Birth trauma, subdural and cerebral hemorrhage and injury to scalp Other specified birth trauma Pulmonary hemorrhage Fetal blood loss affecting newborn Fetal and neonatal intraventricular hemorrhage Fetal and neonatal subarachnoid hemorrhage Fetal and neonatal umbilical hemorrhage after birth Fetal and neonatal gastrointestinal hemorrhage Fetal and neonatal adrenal hemorrhage Fetal and neonatal cutaneous hemorrhage Fetal and neonatal other specified hemorrhage of fetus or newborn Fu Associates, Ltd. 58 January 2013

10 772.9 Fetal and neonatal unspecified hemorrhage of newborn Unspecified fetal and neonatal jaundice Hemorrhagic disease of the newborn Transient neonatal thrombocytopenia Disseminated intravascular coagulation in newborn Other transient neonatal disorders of coagulation Polycythemia neonatorum Congenital anemia Anemia of prematurity Transient neonatal neutropenia Other specified transient hematological disorders Unspecified hematological disorder specific to newborn Syncope and collapse Edema Jaundice, unspecified, not of newborn Spontaneous ecchymosis Epistaxis Hemorrhage from throat Gangrene Shock without mention of trauma Shortness of breath Hemoptysis, unspecified Acute idiopathic pulmonary hemorrhage in infants (AIPHI) Other hemoptysis Chest pain, unspecified Precordial pain Chest pain, other Abdominal pain Hepatomegaly Malignant ascites Other ascites Colic Abnormal coagulation profile Euthyroid sick syndrome Hemoglobinuria Abnormal Liver Function Study Fracture of vault of skull Fracture of base of skull Fracture of face bones Other and unqualified skull fractures Multiple fractures involving skull or face with other bones Fu Associates, Ltd. 59 January 2013

11 Fracture, vertebral column Fractures of rib(s), closed Fracture of rib(s), open Unspecified fracture of pelvis Ill-defined fractures of bones of trunk Fracture of clavicle Fracture of scapula Fracture of humerus Fracture of radius and ulna, upper end, open Shaft, open Lower end, open Fracture unspecified part, open Multiple fractures involving both upper limbs, closed and open Fracture of neck of femur Fracture of tibia and fibula Other multiple lower limb Subarachnoid subdural, and extradural hemorrhage, following injury, Other and specified intracranial hemorrhage following injury Traumatic pneumothorax and hemothorax Injury to heart and lung Injury to other and unspecified intrathoracic organs Injury to gastrointestinal tract , Adding to Injury to gastrointestinal tract Injury to liver Injury to spleen Injury to kidney Injury to pelvic organs Injury to other intra-abdominal organs Internal injury to unspecified or ill defined organs Injury to blood vessels of head and neck Injury to blood vessels of the thorax Injury to blood vessels of the abdomen and pelvis Injury to blood vessels of upper extremity Injury to blood vessels of lower extremity and unspecified sites Contusion with intact skin surface Crushing injury Secondary and recurrent hemorrhage Injury, unspecified site Poisoning by agents primarily affecting blood constituents Toxic effect of alcohol 981 Toxic effect of petroleum products Fu Associates, Ltd. 60 January 2013

12 Toxic effects of solvents other than petroleum-based Toxic effect of other gases, fumes or vapors Toxic effect of other substances chiefly non-medicinal as to source Unspecified adverse effect of unspecified drug, medicinal and biological substance Arthus phenomenon Failed moderate sedation during procedure Other drug allergy Unspecified adverse effect of other drug, medicinal & biological substance Complication of transplanted liver Iatrogenic cerebrovascular infarction or hemorrhage Retained cholelithiasis following cholecystectomy Other digestive system complications Hemorrhage or hematoma complicating a procedure Other vascular complications Transfusion reaction, unspecified Hemolytic transfusion reaction, incompatibility unspecified Acute hemolytic transfusion reaction, incompatibility unspecified Delayed hemolytic transfusion reaction, incompatibility unspecified Other transfusion reaction V08 Asymptomatic HIV infection V12.1 History of nutritional deficiency V12.3 Personal history of diseases of blood and blood-forming organs V12.50-V12.55, V12.59 Personal history of transient ischemic attack, cerebral infarction, or pulmonary embolism without residual deficits V15.1 Personal history of surgery to heart and great vessels V15.21 Personal history of undergoing in utero procedure during pregnancy V15.22 Personal history of undergoing in utero procedure while a fetus V15.29 Surgery to other organs V42.0 Kidney replaced by transplant V42.1 Heart replaced by transplant V42.2 Heart valve replaced by transplant V42.6 Lung replaced by transplant V42.7 Liver replaced by transplant V42.81-V42.89 Other specified organ or tissue replaced by transplant V43.21-V43.22 Heart replaced by other means V43.3 Heart valve replaced by other means V43.4 Blood vessel replaced by other means V58.2 Transfusion of blood products V58.61 Long-term (current) use of anticoagulants V58.83 Encounter for therapeutic drug monitoring Fu Associates, Ltd. 61 January 2013