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Code update for home prothrombin time monitoring

April 13, 2018

The ICD-10-CM guidelines for coding home prothrombin time monitoring have recently been updated to further define the medically necessary indications. Therefore, Independence is updating our policies on home prothrombin time monitoring to reflect these coding changes.

The following policies were posted as Notifications on April 3, 2018, and will go into effect July 2, 2018:

  • Commercial: #05.00.26g: Home Prothrombin Time Monitoring
  • Medicare Advantage: #MA05.016d: Home Prothrombin Time Monitoring

Additions

The following ICD-10 codes have been added as medically necessary indications for pulmonary embolism and venous thromboembolism:

ICD-10 code

Code description

I27.24

Chronic thromboembolic pulmonary hypertension

I80.8

Phlebitis and thrombophlebitis of other sites

Deletions

The following ICD-10 code has been removed because there are more specific codes for the indication of chronic atrial fibrillation:

ICD-10 code

Code description

I48.91

Unspecified atrial fibrillation

For more information

To view the Notifications for these policies, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select Commercial or Medicare Advantage under Active Notifications.


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