tci Medicare Compliance & Reimbursement - 2003 Issue 26

Coverage: ICD COVERAGE EXPANDS- BUT ONLY SLIGHTLY

Health care providers will soon be able to bill Medicare for implantable cardioverter defibrillators in more circumstances. But the extent of the ICD coverage expansion is not as broad as many had hoped. The Centers for Medicare & Medicaid Services announced June 6 that it will be adding the following two indications to Medicare coverage: patients with coronary artery disease with prior myocardial infarction, left ventricular ejection fraction of less than or equal to 0.35, and inducible, sustained ventricular tachycardia or ventricular fibrillation at electrophysiological study; and patients with a prior heart attack and left ventricular ejection fraction...

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