What are the eligibility and coverage criteria for home PT INR monitoring?
Effective for claims with dates of service on and after March 19, 2008, the Centers for Medicare & Medicaid Services (CMS) revised its National Coverage Determination (NCD) on Prothrombin Time (PT/INR) Monitoring for Home Anticoagulation Management. Medicare now covers the use of home PT/INR monitoring for chronic, oral anticoagulation management for patients with: • mechanical heart valves, • chronic atrial fibrillation and • venous thromboembolism (inclusive of deep venous thrombosis and pulmonary embolism) The monitor and the home testing must be prescribed by a treating physician and all of the following requirements must be met: 1. The patient must have been anticoagulated for at least 3 months prior to use of the home INR device; and, 2. 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, 3. The patient continues to correctly use the device in the cont
