Followup on PT/INR … the flipside

Shortly after I posted on PT/INR, I received a question about what to do when the PT/INR fluctuates, which makes the Coumadin dosing also fluctuate. Is that enough to keep a patient admitted in home health?
Medical necessity is the key. In this case, the medically necessary service that you’re providing is observation and assessment. O and A is medically necessary when there exists a potential fluctuating condition that requires the skills of a nurse to assess and intervene.

Document well.

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