About this policy
CMS National Coverage Determination | ncd_id=269 | manual_section=190.11 | coverage_level_code=2 | national_coverage_type=True | under_review=True | lab_ncd=False
Coverage indications
B. Nationally Covered Indications For services furnished on or after March 19, 2008, Medicare will cover for the use of home PT/INR monitoring forchronic, oral anticoagulation management for patients with mechanical heart valves, chronic atrial fibrillation, or venous thromboembolism (inclusive of deep venous thrombosis and pulmonary embolism) on warfarin. The monitor and the home testing must be prescribed by a treating physician as provided at 42 CFR 410.32(a), and all of the following requirements must be met: The patient must have been anticoagulated for at least 3 months prior to use of the home INR device;and, The patient must undergo a face-to-face educational program on anticoagulation management and must have demonstrated the correct use of the device prior to its use in the home; and, The patient continues to correctly use the device in the context of the management of the anticoagulation therapy following the initiation of home monitoring; and, Self-testing with the device should not occur more frequently than once a week. C. Nationally Non-Covered Indications N/A D. Other 1. All other indications for home PT/INR monitoring not indicated as nationally covered above remain at local Medicare contractor discretion. 2. This national coverage determination (NCD) is distinct from, and makes no changes to, the PT clinical laboratory NCD at section 190.17 of Publication 100-03 of the NCD Manual. (This NCD last reviewed March 2008)
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.