Which Patients Qualify for INR Home Testing

Most long-term Coumadin® users qualify for INR home monitoring coverage through Medicare.

Medicare patients that meet the following conditions are eligible for home monitoring:

  1. The patient must have been anticoagulated for at least 3 months prior to use of the home INR device;
  2. The patient must undergo a face-to-face educational program on anticoagulation management and must have demonstrated the correct use of the device prior to its use in the home;
  3. The patient continues to correctly use the device in the context of the management of the anticoagulation therapy following the initiation of home monitoring;
  4. Self-testing with the device should not occur more frequently than once a week.
  5. Have one of the following Diagnosis (See ACS’ prescription form for all approved Diagnosis Codes for home INR testing)
  • Mechanical Heart Valve
  • Chronic Atrial Fibrillation
  • Deep Vein Thrombosis (DVT)
  • Pulmonary Embolism
  • Hypercoagulable State

The majority of patients with private insurance qualify for home monitoring. Each health plan is different, and some may require a prior authorization before approving services, regardless of the patient’s diagnosis. Advanced Cardio Services is contracted with Blue Shield, Humana, Coventry National, and other insurances for our home INR testing service.

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