tci Medicare Compliance & Reimbursement - 2008 Issue 14

Revenue Booster: CMS Allows Expanded Payment For At-Home INR Tests

Patients using warfarin for chronic atrial fibrillation or venous thromboembolism are covered Last week, CMS opened the door to new payment rules governing prothombin time testing, and this time, the new rules expanded coverage, rather than restricting it. Medicare will now cover prothombin time international normalized ratio (INR) for patients using warfarin to treat chronic atrial fibrillation or venous thromboembolism. In the past, Medicare allowed home testing coverage only for beneficiaries with mechanical heart valves who took warfarin. Under the new policy, "the patient would have to first be anticoagulated for three months or longer before implementing home monitoring...

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