Summary & Overview
HCPCS S9401: Anticoagulation Clinic Visit, Excluding Laboratory Tests
HCPCS Level II code S9401 designates a clinic-based anticoagulation management session that encompasses all services provided during a visit except laboratory testing. This code is used to capture structured, non-laboratory components of anticoagulant care—such as medication reconciliation, dose adjustment, counseling, and care coordination—across outpatient anticoagulation clinics and ambulatory settings. Nationally, standardized reporting for anticoagulation services supports quality tracking and payment consistency for an important population at risk for bleeding and thrombotic events.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical scope and service context, an overview of common modifiers and billing considerations provided in the input, and guidance on where gaps in available data exist. The publication highlights benchmarks and policy-relevant considerations tied to use of S9401, summarizes typical service lines and sites of care, and identifies areas where additional documentation or coding specificity is commonly required. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
HCPCS Level II code S9401 describes an anticoagulation clinic visit that includes all clinical services provided during a session except laboratory tests. The service is focused on management and monitoring of patients receiving anticoagulant therapy, including medication review, dose adjustment, patient education, and care coordination.
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Service type: Anticoagulation management visit, clinic-based outpatient service
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Typical site of service: Outpatient anticoagulation clinic or ambulatory care setting
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with non-valvular atrial fibrillation on chronic oral anticoagulation who presents to an outpatient anticoagulation clinic for management of warfarin therapy. The clinic session includes medication reconciliation, assessment of bleeding or thrombotic symptoms, review of home INR or point-of-care INR results (laboratory testing itself is excluded from this code), dosage adjustment, patient education on drug and dietary interactions, documentation of plan and follow-up, and coordination with the patient’s primary care physician or cardiologist. The visit is provided in an ambulatory clinic setting or specialized anticoagulation service within a hospital outpatient department. Typical workflow: check-in and verification of medications and history; focused interview on bleeding/thrombotic events and adherence; review of INR result if available; calculation and communication of new warfarin dose or confirmation of DOAC adherence; education and scheduling of next appointment; documentation and electronic messaging to referring providers. Ancillary services such as laboratory testing, dispensing of medication, or extended chronic care management are not included in this per-session code.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier specified; often default | Use when no other applicable modifier applies to the service |