Automate intake, eligibility, and PA with AI agents that work in your EMR and billing systems.

Contact us to get started

Create a free account to automate medical coding. Just upload a chart and get codes.

Create Free Account

Anthem Blue Cross Connecticut Commercial Clinical Policy

Anthem Blue Cross Connecticut CG-DME-30 Prothrombin Time Self-Monitoring Devices Form

Effective Date

01/03/2024

Last Reviewed

11/09/2023

Original Document

  Reference



This document addresses the clinical indications for use of battery-operated prothrombin time self-monitoring devices, also referred to as International Normalized Ratio (INR) devices, used by individuals in the home to monitor blood-clotting rates.

Clinical Indications

Medically Necessary:

Home prothrombin time self-monitoring using an INR device is considered medically necessary for an individual who meets all of the following criteria:

  1. Requires long term (greater than one year) anticoagulation with warfarin; and
  2. Requires at least weekly determinations of INR values; and
  3. The treating physician prescribes the self-monitoring device and home testing.

Not Medically Necessary: 

Home prothrombin time self-monitoring is considered not medically necessary for an individual who does not meet the above criteria.