medicare approved

Important Facts*

  • Patient self-testing for anti-coagulation therapy originally approved in July, 2002 for mechanical heart valves
  • CMS expanded use for chronic Atrial Fibrillation and Deep Vein Thrombosis in March, 2008 (National Coverage Decision); many private carriers have yet to issue coverage decisions and those already in place vary considerably
  • Current CPT codes:
    • G0250–Physician interpretation of test results (approximately $8.00-$10.00 per every four interpretations; actual amounts provided upon request)
    • G0248-Patient training (must meet certain specific criteria, provided upon request)
  • ICD-9 codes covered (if selection criteria are met):
    • V43.3 (organ or tissue replaced by other means; heart valve)
    • 289.81 (primary hypercoagulable state)
    • 451.0-451.9 (phlebitis & thrombophlebitis)
    • 453.0-453.3 (other venous embolism & thrombosis)
    • 415.11-415.19 (pulmonary embolism & infarction)
    • 427.31 (atrial fibrillation (established)(paroxysmal))

*This information is subject to change and may vary from any actual reimbursements from Medicare or other insurance carriers. CardioNet obtained this information from sources believed to be reliable, and no express or implied warranty is made or assumed regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of any such information.