Part B Insider (Multispecialty) Coding Alert
CMS Expands Coverage for Prothrombin Time to Include Additional Diagnoses
Plus: CMS offers a new resource for billing and coding preventive services to Part B.
The new decision, which CMS issued on Jan. 23, notes that CMS previously covered prothrombin time monitoring only for patients with mechanical heart valves who were on warfarin.
The new change, however, will allow practices to bill this service for chronic, oral anti-coagulation management in patients with mechanical heart valves, chronic atrial fibrillation, or venous thromboemoblism, according to a MLN Matters article on the topic.
Patients must meet the following criteria to qualify:
• The patient must have been anticoagulated for at least 3 months prior to use of the home INR device
• The patient must undergo an educational program on anticoagulation management and the use of the device prior to its use in
the home
• Self-testing with the device should not occur more frequently than once a week.
Even better: CMS has made this change retroactive to March 19, 2008.
For more information on the new national coverage decision, visit the CMS Web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6138.pdf.
In other news ...
• If your head spins when you try to make sense out of coding and billing for Medicare's preventive services, CMS has a new tool that can help.
CMS' Expanded Benefits Brochure provides health care professionals with an overview of Medicare's coverage of three preventive services: the Welcome to Medicare Exam, ultrasound screening for abdominal aortic aneurysms, and cardiovascular screening blood tests.
To view the brochure, visit the CMS Web site at http://www.cms.hhs.gov/MLNProducts/downloads/Expanded_Benefits.pdf.
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CMS Expands Coverage for Prothrombin Time to Include Additional Diagnoses
Plus: CMS offers a new resource for billing and coding preventive services to Part B. CMS [...]
