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Home Prothrombin Time INR Monitoring for Anticoagulation Management
Use of the International Normalized Ratio (INR) allows physicians to determine the level of anticoagulation in a patient independent of the laboratory reagents used. The INR is the ratio of the patient's prothrombin time compared to the mean prothrombin time for a group of normal individuals. Maintaining patients within the therapeutic range minimizes adverse events associated with inadequate or excessive anticoagulation such as serious bleeding or thromboembolic events. Patient self-testing and self-management through the use of a home INR monitor may be used to improve the time in therapeutic rate (TTR) for select groups of patients. Increased TTR leads to improved clinical outcomes and reductions in thromboembolic and hemorrhagic events.
For services furnished on or after July 1, 2002, Medicare will cover for the use of home prothrombin time INR monitoring for anticoagulation management for patients with mechanical heart valves on Warfarin. Home prothrombin monitoring with the use of INR devices is covered only for patients with mechanical heart valves. The monitor and the home testing must be prescribed by a treating physician as provided at 42 CFR 410.32(a) and the following requirements must be met:
05/2002 - Provided coverage for patients with mechanical heart valves when certain conditions have been met under the Medicare program. Effective and implementation dates 07/01/2002. (TN 156) (CR 2071)
This NCD has been or is currently being reviewed under the National Coverage
Determination process. The following are existing associations with NCAs, from the National
Coverage Analyses database.