Traditional MedicareCoverageMedium impact
Partial Thromboplastin Time (PTT)
Medicare/CMS - NCD·Hematology, Cardiology, Critical Care +1 more·National Coverage Determination
We identified it
Oct 2, 2026
Summary
This is a National Coverage Determination for Partial Thromboplastin Time (PTT) testing, a laboratory test used to evaluate blood clotting disorders. The policy establishes Medicare coverage parameters for PTT testing. Without access to the full policy details beyond the metadata provided, specific coverage criteria, limitations, or billing changes cannot be determined from this source.
Action Required
Billing team should obtain and review the complete National Coverage Determination 190.16 text from the CMS Medicare Coverage Database at https://www.cms.gov/medicare-coverage-database/data/ncd?ncdid=74&ncdver=1. Once obtained, identify: (1) specific CPT or HCPCS codes affected, (2) any coverage limitations or medical necessity requirements for PTT testing, (3) prior authorization requirements if applicable, and (4) any frequency or bundling restrictions. Update billing system rules and provider documentation requirements accordingly before submitting PTT claims to Medicare. Claims submitted without compliance to the new determination may be subject to denial or recoupment.