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Coding Analysis for Labs (CAL) Tracking Sheet for Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) tests (Removal of Unspecified Joint Replacements) (CAG-00246N)



[Coding determinations made as part of the Coding Analysis for Laboratory (CAL) process do not constitute National Coverage Determinations (NCDs), but only serve to provide clarification on codes that are covered under a particular laboratory negotiated NCD.]

The current national coverage determinations (NCDs) for PT and PTT include ICD-9-CM code V43.60, Unspecified joint replaced by other means, in the list of ICD-9-CM Codes Covered by Medicare. It is not evident that this code flows from anything included in the narrative covered indications for these tests. Coverage of this unspecified joint replacement without coverage of specified joint replacements is confusing. We will be reviewing this code more carefully with the benefit of public comment to make a determination if they should be removed from the list of covered diagnoses.

Diagnostic Laboratory Tests
Requestor Name(s)Internally generated
Formal Request Accepted and Review Initiated06/24/2004
Expected NCA Completion Date09/24/2004
Public Comment Period06/24/2004 - 07/24/2004
Decision Memo Released07/27/2004
Lead Analyst(s)
  • Jackie Sheridan-Moore

June 24, 2004

Tracking sheet posted to the Internet.

July 27, 2004

Posted coding analysis.

November 26, 2004

Published implementing instructions  in transmittal 380 or pub 100-4 (CR3429)
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