Physician Reimbursement Primer for Cardiac ... - Boston Scientific

Chapter 3
Cardiac Resynchronization Therapy Pacemakers (CRT-Ps)
At this time there is no specific NCD for CRT-Ps. However, some Medicare contractors
have developed LCDs for CRT-P that apply to certain regions. It is important for medical
providers to check with their local Medicare contractor or non-Medicare payers to
determine patient coverage and coding/billing guidelines.
Cardiac Resynchronization Therapy Defibrillators (CRT-Ds)
At this time there is no specific NCD for CRT-Ds. However, some Medicare contractors
have developed LCDs for CRT-D that apply to certain regions. It is important for medical
providers to check with their local Medicare contractor or non-Medicare payers to
determine patient coverage and coding/billing guidelines.
Intracardiac Electrophysiology and Related Procedures
Some cardiovascular procedures, such as pacemakers and cardioverter defibrillators,
contain very clear national coverage criteria as defined by CMS. Other procedures, such
as electrophysiology studies (EPS), do not have clearly defined coverage criteria at the
national level. Some Medicare contractors have developed LCDs for EPS that apply to
certain regions. It is important for providers to check with their local Medicare contractor
or non-Medicare payers to determine patient coverage and coding/billing guidelines.
Note: Search the Medicare Coverage Database on the CMS website
(http://www.cms.hhs.gov/mcd/search.asp) for coverage descriptions and updates.
22 Physician Reimbursement Primer for Cardiac Rhythm Management