Medicare Expands Coverage For Home Blood Testing Of Prothrombin Time International Normalized Ratio

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Blood / Hematology
Article Date: 20 Mar 2008 - 2:00 PST

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The Centers for Medicare & Medicaid Services (CMS) today expanded Medicare coverage for home blood testing of prothrombin time (PT) International Normalized Ratio (INR) to include beneficiaries who are using the drug warfarin, an anticoagulant (blood thinner) medication, for chronic atrial fibrillation or venous thromboembolism.

Medicare's prior policy only provided home test coverage for Medicare patients with mechanical heart valves who are on warfarin.

"Those Medicare beneficiaries and their physicians managing conditions related to chronic atrial fibrillation or venous thromboembolism will benefit greatly through the use of the home test," CMS Acting Administrator Kerry Weems said. "Medicare's coverage extension of home blood testing of prothrombin time International Normalized Ratio is based on current evidence for these two conditions."

Atrial fibrillation is an electrical disturbance of the heart that produces an irregular heart rhythm and increases the risk of stroke from blood clots forming in the heart chambers and then traveling to the brain. Patients with venous thromboembolism experience blood clots, usually in the legs, which may break off and travel to the lungs - a potentially fatal complication.

Patients use PT/INR blood testing to determine how well their anticoagulant medicine is working to prevent blood clots. PT measures the speed of blood coagulation, while INR provides a way to standardize such measurement. Tests can be performed at home, as long as the patient works with his or her health care provider as part of an anticoagulation management program.

The National Coverage Determination announced today can be found at www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=209.