AHA Coding Clinic® for HCPCS - 2010 Issue 3; ASK the EDITOR

Dilute Russell's Viper Venom

Dilute Russell’s Viper Venom time (DVV) is a test we perform to test for lupus anticoagulation. Two distinct reagents exist for this test, a DVV test reagent (low phospholipid) and DVV confirm reagent (high phospholipid), if needed. The concentration of snake venom is the same in both as is the test set-up (one part patient plasma and one part reagent). The patient’s plasma is run with the DVV test (low phospholipid) reagent to determine the clotting time in seconds. The patient’s clotting time is divided by the normal control clotting time to attain a ratio. If the ratio is less than 1.3, the test is stopped – patient is “negative” (approximately 80% of our patient population). If the ratio is equal to or greater than 1.3 we repeat the test using the DVV confirm reagent (high phospholipid) to verify that the patient is truly “positive”. We divide the patient’s DVV test time by the patient’s DVV confirm time and if it is less than 1.3 ration then patient is “negative”, if above 1.3 the patient is “positive”. Approximately 20% of our population requires confirmatory testing. The test results indicate the initial test ratio, the confirmatory ratio as well as a final positive or negative result. When the confirmatory test is performed, is it appropriate to bill an additional unit of CPT code 85613, Russell viper venom time (includes venom); diluted, for the confirmatory test performed with a different reagent? ...

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