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AetnaAll Plans · Coverage · Medical Policy · Cardiology, Hematology, Internal MedicineMedium impact

Prothrombin Time (INR) Home Testing Devices (CPB 0173, reviewed 2026-03-20)

Effective date
Not stated in the notice
Identified
Aug 14, 2026

Summary

Aetna clinical policy bulletin 0173 considers prothrombin time (INR) home testing units medically necessary durable medical equipment for patients on chronic warfarin for a mechanical heart valve, ventricular assist device, chronic atrial fibrillation, deep venous thrombosis, pulmonary embolism, venous embolism and thrombosis of deep vessels of the lower extremity, or hypercoagulable states, when the expected need for home INR testing is 6 or more months, the patient has been anticoagulated for at least 3 months before using the device, and self-testing does not occur more than once a week. Aetna considers the units experimental, investigational, or unproven for all other indications, including arterial embolism to the eye, atrial flutter, and Kawasaki disease.

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What to do

Action · 6 steps
01Billing team: before billing CPT 93792 for patient or caregiver training for home INR monitoring, confirm the training was given face-to-face under the direction of a physician or other qualified health care professional and that the record documents the patient's or caregiver's ability to perform testing and report results.
02Bill CPT 93793 for anticoagulant management of a patient taking warfarin only when the note includes review and interpretation of a new home, office, or lab INR result, patient instructions, dosage adjustment as needed, and scheduling of additional tests when performed.
03Confirm the diagnosis is one of the covered indications, that the patient has been anticoagulated for at least 3 months before home INR device use, and that the expected need for home INR testing is 6 months or more.
04For Medicare patients who meet Medicare coverage criteria, HCPCS G0248 requires a face-to-face demonstration of the monitor and at least one blood sample, and G0249 for test materials and equipment and G0250 for physician review and interpretation are not billed more frequently than once a week.
05The monitor and home testing must be prescribed by a treating physician, and the patient must complete an educational program on anticoagulation management and demonstrate correct use of the device before using it at home.
06Hardware and software used to download home INR data to computers are considered not medically necessary convenience items, so do not bill them as medically necessary.

Codes mentioned

9379293793G0248G0249G0250D68.51D68.62I26.01I26.99I26.90I27.82I48.0I48.11I48.19I48.20I48.21I48.91I80.00I80.9I82.401I82.5Z9I82.621I82.629I82.721I82.729T80.0XXAT80.0XXST81.718AT81.718ST82.817AT82.818SZ95.2Z95.811H34.9I48.3I48.4I48.92M30.3

Original notice

Prothrombin Time (INR) Home Testing Devices (CPB 0173, reviewed 2026-03-20)
aetna.com · Always check the source before changing claims.
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