At-home monitoring of chronic warfarin therapy may be considered medically necessary in patients who require continuous anticoagulation use for long term (>6 months) or life – long coagulation for any of the following chronic medical conditions:
Mechanical heart valves
Chronic atrial fibrillation
Venous thromboembolism inclusive of deep vein thrombosis (DVT) and pulmonary embolism
Ventricular Assist Devices (VAD)
Hypercoagulable states
All the following criteria must be met for home PT/INR Monitoring:
The device must be Food and Drug Administration – approved
The patient must have been anticoagulated for at least 3 months prior to use of the home INR device;and,
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; and,
The patient continues to correctly use the device in the context of the management of the anticoagulation therapy following the initiation of home monitoring; and,
The expected need for home INR testing is 6 or more months;
Self-testing with the device should not occur more frequently than once a week.
The use of home monitoring during the initial treatment period is considered investigational.
Testing more frequently than once per week is generally considered investigational.
