Coding Analysis for Labs (CAL) Tracking Sheet

Prothrombin Time and Fecal Occult Blood (Revision of ICD-9-CM Codes for Injury to Gastrointestinal Tract)



The current national coverage determination (NCD) for Prothrombin Time (PT) and Fecal Occult Blood Tests (FOBT) includes ICD-9-CM codes 863.0-863.90, injury to gastrointestinal tract, in the list of covered diagnoses.  We are considering adding the remaining codes in the 863.90-863.99 series.  Specifically, we are considering adding the following codes to the list of covered diagnoses for PT and FOBT: 863.91, open wound, pancreas head; 863.92, open wound, pancreas body; 863.93, open wound, pancreas tail; 863.94 open wound, pancreas, multiple and unspecified sites; 863.95 open wound, appendix; and 863.99 open wound, other gastrointestinal sites.

Benefit Category

Diagnostic Laboratory Tests

Requestor Information

Requestor Name Requestor Letter
Internally Generated N/A

Important Dates

Formal Request Accepted and Review Initiated
Expected CAL Completion Date
Public Comment Period
07/03/2003 - N/A
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released


Lead Analysts
Jackie Sheridan-Moore
Lead Medical Officers

Medicare Benefit Category Determination Date

Actions Taken

June 3, 2003

Opened formal NCD request and posted tracking sheet on the Internet.

September 17, 2003

Posted decision memo on the Internet.