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Many	 of	 your	 patients	 are	 predisposed	 to	 hyper-metabolize	
certain	 drugs,	 which	 can	 lead	 to	 critical	 adverse	 reactions.		
Many	more	will	hypo-metabolize	medications	to	the	point	that	
they	are	virtual	placebos.		PGx,	or	Pharmacogenomics	Testing	
is	an	easy,	inexpensive,	CMS	recommended	way	to	determine	if	
medication	is	ineffective	or	worse,	dangerous.			
	
PGx	America	Corp.	has	developed	a	simplified	process	that	will	
let	 your	 practice	 access	 this	 critical	 tool	 without	 any	
investment	 or	 additional	 staff	 burden.	 You	 will	 learn	 the	
critical	 technologies	 that	 are	 reshaping	 the	 future	 of	
diagnostics	today.		Therapeutic	Drug	Monitoring	with	PGx	tests	
will	greatly	increase	the	scope	of	bodily	systems	reviewed	in	
any	 clinical	 situation.	 	 	 Our	 strategies	 make	 sure	 that	 your	
practice	is	adequately	reimbursed	by	emphasizing	compliance	
and	transparency.
1)	 the	NURSE																						 																	
	
It	all	begins	with	the	nurse	who	identifies	a	patient	matching	critical	CMS	criterion	
as	seriously	at	risk	of	Adverse	Drug	Reaction.			
-	Number	of	medications.		Four	or	more	prescribed	medications	can	indicate	
	 a	high	risk.	
-	Nature	of	medications.	Cardio	and	vascular	medications	including	statins	or	
psychiatric	drugs	including	anti-depressants	are	frequently	adverse.	
	
When	both	number	and	nature	of	criterion	are	met	nurse	may	proceed	to	take	
buccal	swab,	20	seconds	per	side	of	mouth.		Bag	and	label	swabs.		Notify	practitioner	
that	Therapeutic	Medication	Monitoring	Encounter	is	advised.		Nurse	may	also	pull	
swab	kit	for	practitioner	to	administer.	
	
																										2)							the	DOCTOR																																																										
	
The	physician	should	initiate	a	Therapeutic	Drug	Monitoring	Encounter	with	patient	
due	to	concerns	with	number	and	nature	of	drugs	taken.			Ask	for	patients	
perception	of	the	effectiveness	and	suspected	side	effects	of	each	medication.		
	
Charting	should	be	simple	but	specific.		E&M	level	should	be	elevated	due	to	
increase	scope	of	body	systems	reviewed.		Indicate	that	physician	initiated	
Therapeutic	Drug	Monitoring	Encounter	due	to	concerns	of	number	and	nature	of	
medications,	and	specify	cardio-vascular	or	psychiatric	medication	with	concern.	
An	E&M	increase	of	2	levels	is	only	indicated	in	a	case	where	the	patient	may	be	
experiencing	a	critical	adverse	reaction.		Never	indicate	that	a	test	is	being	
performed	to	“rule	out”	a	cause,	but	rather	to	prove	a	presumption	.
3)						the	BILLER																																																								
	
Whether	the	doctor	or	a	transcriptionist	charts	the	visit	it	is	vitally	important	to	
note	the	Therapeutic	Medication	Monitoring	Encounter	along	with	the	concerns	due	
to	number	and	nature	of	medications.		Even	if	a	test	is	not	determined	to	be	
necessary	after	the	review,	the	review	itself	is	medically	necessary	if	patient	is	
taking	4	or	more	prescription	medications	including	cardio	or	psych	drugs.			Thus	
E&M	coding	should	reflect	that	increase	in	scope	of	body	systems	review.	
	
-If	a	swab	is	administered	use	an	appropriate	local	fee.			
-Therapeutic	Drug	Monitoring	Encounter:		
Z51.81		Z79.01	for	long	term	use	of	anti-coagulants	excluding	aspirin	
Or:	ICD-10-CM	Z79.899	Other	long	term	(current)	drug	therapy		
	
	
	
4)							the		LAB																																											 	
	
In	72	hours	the	lab	will	securely	send	the	comprehensive	pharmacogenomics	test	
results	to	the	practice	for	physician	to	review.		It	is	color	coded	to	readily	identify	
issues	of	concern	including	necessary	dosing	changes.		A	laboratory	technician	will	
be	waiting	by	the	phone	for	your	call	to	answer	all	of	your	questions	and	explain	the	
results	in	as	high	a	detail	as	you	would	like	to	go.		Our	people	are	your	people.		It’s	
like	we	are	just	down	the	hall,	any	time,	every	day.
Pharmacogenomic	 testing	 will	 be	 a	 common	 tool	 in	 the	 21st	
century	doctors’	bag.				After	just	a	couple	tests	this	will	be	a	
seamless	and	integral		part	of	your	practice.		As	more	and	more	
tests	 are	 available	 you	 will	 stay	 on	 the	 leading	 edge	 of	
diagnostic	medicine.		PGx	America	will	guide	you	along	the	way	
incorporating	this	diagnostic	miracle	into	your	practice.	
	
The	only	way	to	start	is	by	starting.				Today.			We	will	be	with	
you	every	step	of	the	way.	
	
	
For	help	with	your	account	please	call	your	Account	Executive	
Arney	Benson	at	:	
	 1	(480)	399	-	2877	
	
	
	
	
	
2015	PGx	AMERICA	CORP		v		WASHINGTON		PA		USA

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