Fingerstick Protimes

love using the pt/inr machines!! results have been equal or extremely close to the venipuncture -- remember when writing your md order to include may use fingerstick or venipuncture then you are covered.

Our agency just got a couple of them. They haven't been used yet, but it will be in the near future. I'm looking forward to it.

This machine is good and bad...at least at our office. There are times where we have to 'poke' the finger 5-6 times before we get the right result. It seems the machine doesn't work if too hot...too cold....battery at half life.....I don't know. maybe someone has some advice to get this machine to work every time. once nurse can use it....and get the result the first time...the next nurse that uses it.....doesn't get the right result until the 5th test strip! It is good on the ones where you can get a butterfly to draw blood to save your life....but I don't know...I like it...but then sometimes I don't like it!!! ya think for a machine that cost 1400.00 it would work!

We've been using the machines now for several weeks. At first we had a couple results that didn't seem right, so we went ahead and did a venipuncture protime to verify accuracy. So far they have all been close in results. We had an extensive inservice and they aren't as simple as glucometers, that's for sure. The machine has to be at room temp; it has to be on a hard level surface; once you place the strip in the machine you cannot bump or touch the machine as it may affect the results. As far as having to stick people more than once...I've not had to do that, except for in those early cases when the results didn't quite go with what the patient had been running with inr's in the past. I'm getting more confident and comfortable with them.

We use them all the time. I have had good and bad results with them. Sometimes I have to stick more than once. As a whole though, I would say that I like having the results right then and can call and get change in dosages.

We have them and I don't like them. I can never get a result on a patient. It always says not enough sample even with a pool of blood on the test strip. I would rather do a blood draw than mess with those machines.

Our company has just upgraded to the CoaguChek PT Test machine. This is much better than the older ones with the cuve (I think that is what those strips were called). You use a capillary tube, after you use a small lancet--thus needing much less blood. It is so much quicker than the old machines, I have less problems. I have been told that it is more accurate than venipuncture, because you are using whole blood, without as much interference, such as how the person draws it, how much time it takes to get to the lab, right down to how the lab performs their test. I love it, especially on the days where I would have to drive 40 minutes to the closest lab. Of course, you have to fight one another for the machine, even making deals with each other, just to get it.

We also use the machines where you collect in capillary tubes after the fingerstick. We use a machine called INRatio. I have been lucky this week....2 days in a row I was able to get orders right at the patient's home.....that doesn't happen too often. I know what you mean about nurses fighting over machines! We only have 2 in our agency so far and it's a circus sometimes. They say whenever the time comes for us to order new strips we will also get another machine. Can't wait for that!

Our agency also uses the coagucheck machines. We have at least one doctor who prefers PT/INRs done this way and states it in his orders.

Question? Does the agency get reimbursed for this stick or is it used as an auxillary service to code for therapy purposes? Does the agency bill medicare separately for the skill and the S.N. visit or is this a courtesy to the MD's?

I believe ours will be the INRatio brand. Next week we will all get our own ECG machines (well, 15 of us that use them for post-op open-heart) and our own pulseoximeters to keep and not return every day.

Question? Does the agency get reimbursed for this stick or is it used as an auxillary service to code for therapy purposes? Does the agency bill medicare separately for the skill and the S.N. visit or is this a courtesy to the MD's?

Medicare will not reimburse an agency for a "lab only" visit (so I have been told). So this visit is combined with a regular visit. If I were to just draw labs, or just do a PT/INR, I would make it a non-billable visit. We also do not bill medicare for blood collection supplies or tubes, along with not charging them for the long ride to and from a lab, so this PT/INR machine saves our agency money.