Coding Analysis for Labs (CAL) Tracking Sheet for Prothrombin Time (PT) (Addition of two ICD-9-CM diagnosis codes)

CMS received an external request to add ICD-9-CM diagnosis code 786.50, Chest pain, unspecified to the list of diagnosis codes covered by Medicare under the NCD for Prothrombin Time (PT) at Section 190.17 of the Medicare National Coverage Determination Manual (NCDM). During internal review at CMS, we determined that the related code 786.51, Precordial pain, also seemed to flow from the narrative of 190.17. A portion of the ’Indications’ section of the policy indicates a PT test might be useful in evaluating a patient with thrombosis such as a myocardial infarction. CMS accepts a request to add ICD-9-CM diagnosis codes 786.50, chest pain unspecified, and upon additional review will also add 786.51, precordial pain, as ICD-9-CM diagnosis codes covered under the NCD on Prothrombin Time at section 190.17 of the Medicare NCD Manual. The 30-day public comment period begins with this date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the test under consideration. Public Comment Period: 05/25/2011 – 06/24/2011