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Heparin

National Coverage Determinations (NCD) Manual (CMS Pub. 100-03, Ch.1, Part 4 §290.2)External PDF

Skilled nursing visits for the administration of heparin injections are payable if:

  1. visits are reasonable and necessary to the treatment of the illness;
  2. the intermittent or part-time requirement is met; and
  3. the beneficiary or caregiver cannot administer the injections.

Subcutaneous injections of low-dose heparin can be considered reasonable and necessary therapy in the treatment of deep venous thrombosis or pulmonary emboli when oral anticoagulants are contraindicated.

Coverage after six months of treatment would be provided only if the prescribing physician can justify the need for such an extended course of treatment.

Updated: 07.30.12

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