Traditional MedicareCoverageMedium impact
Prothrombin Time (PT)
Medicare/CMS - NCD·National Coverage Determination
We identified it
Oct 2, 2026
Summary
This is a National Coverage Determination for Prothrombin Time (PT) laboratory testing. However, the provided policy content does not include specific coverage details, billing codes, effective dates, or changes from previous guidance. Without the full policy text, the billing impact cannot be determined.
Action Required
URGENT: Billing team must retrieve the complete NCD 190.17 policy text from the CMS database link (https://www.cms.gov/medicare-coverage-database/data/ncd?ncdid=80&ncdver=1) to determine: (1) specific PT test billing codes affected, (2) coverage requirements and limitations, (3) any prior authorization requirements, (4) medical necessity documentation standards. Do not process PT claims until full policy content is reviewed. Flag all pending PT claims for manual review once policy details are obtained.