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Coding Analysis for Labs (CAL) Tracking Sheet

Partial Thromboplastin Time (PTT) (Addition of ICD-9-CM V58.83, Encounter for therapeutic drug monitoring, as a covered indication)

CAG-00338N

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Issue

CMS received an external request to add ICD-9-CM V58.83, Encounter for therapeutic drug monitoring, as a covered indication for the Partial Thromboplastin Time (PTT) NCD at 190.16 of the NCD manual.

We are seeking public comment on the addition of code V58.83 to the ICD-9-CM Codes Covered By Medicare list for the PTT NCD.

The regulation for maintaining code lists in the negotiated NCDs for clinical diagnostic laboratory services states that codes on the covered list flow from the existing NCD narratives of covered indication.  The regulation was published February 25, 2005 in the Federal Register, Vol.70, No. 37 and can be viewed at http://www.cms.hhs.gov/Medicare/Coverage/CoverageGenInfo/LabNCDsICD10.html#TopOfPage.

National Coverage Determinations

Benefit Category

Diagnostic Laboratory Tests

Requestor Information

Requestor Name Requestor Letter
Susan K. Taylor Proctor, RHIT, CCS N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
07/24/2006
Expected CAL Completion Date
10/24/2006
Public Comment Period
07/24/2006 - 08/23/2006
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
10/03/2006

Contacts

Lead Analysts
Maria Ciccanti
Lead Medical Officers
Jim Rollins, MD, MSHA, PhD

Medicare Benefit Category Determination Date

Actions Taken

July 24, 2006

CMS accepts a request to add ICD-9-CM code V58.83.0 as a covered indication in the Partial Thromboplastin Time national coverage determination list of covered indications.

The initial 30-day public comment period begins with this acceptance date, and ends after 30 calendar days.  CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the test under consideration.

October 3, 2006

Posted decision memo.
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