J2997 (TPA)

Good Afternoon,

Anyone else having problems with J2997 (TPA) payment, especially Medicare? Please help, any suggestions.



  • Good morning,

    We are internal medicine doctors who often monitor protime and INR results
    (not performed in our office), with blood work drawn by outside home health
    agencies and sent to us for interpretation.

    Referencing the article in the March 2016 issue of PartB News, *AVOID
    ANTICOAGULATION CONFUSION*, it appears you can bill 99441-99449 along with
    a G0250 in a block of 4 tests, and no more than once a week. We have the
    following questions:

    1) What documentation is required for these procedures? Do you have to
    submit the dates of testing along with your claim and if you do, how and
    where do you put it?

    2) Has anyone actually been paid for these codes together?

    3) What restrictions and permissions attributed to these codes and are
    any modifiers required, if so, which ones?

    4) Does it make a difference if labs were performed by an outside lab or
    a patient's personal PT & INR machine?

    5) Any other tips or suggestions?

    Any help would be appreciated!

    Penny Sue
    Century City Primary Care, LLC
    (310) 553-4982

    Penny Sue
    Century City Primary Care, LLC
    (310) 553-4982 office
    (310) 729-2758 cell

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