Coding Analysis for Labs (CAL) Tracking Sheet

Prothrombin Time and Partial Thromboplastin Time (Revision of ICD-9-CM Codes for Swelling of Limb)

CAG-00201N

Issue

The current national coverage determinations (NCD) for prothrombin Time (PT) and partial thromboplastin time (PTT) include in the narrative indications the assessment of patients with signs or symptoms of hemorrhage or thrombosis.  One such indication is “swollen extremity with or without prior trauma.”  However, the list of ICD-9-CM codes covered by Medicare does not include code 729.81, swelling of limb.   We will be examining the PT and PTT NCDs to determine if it is appropriate to add code 729.81 to the list of ICD-9-CM codes covered by Medicare.

Benefit Category

Diagnostic Laboratory Tests

Requestor Information

Requestor Name Requestor Letter
Linda Minor, Brookings Hospital, Brookings, SD N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
08/15/2003
Expected CAL Completion Date
06/18/2004
Public Comment Period
08/15/2003 - 09/15/2003
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
06/18/2004

Contacts

Lead Analysts
Jackie Sheridan-Moore
Lead Medical Officers

Medicare Benefit Category Determination Date

Actions Taken

August 15, 2003

Formal request accepted by CMS.

June 18, 2004

July 9, 2004

Issued implementing instructions.