Appendix E - National Coverage Determinations Manual / HEART_TRANSPLANTS

Why This Topic Matters

Heart transplant coverage depends on specific Medicare policy conditions and facility standards, so understanding the scope of this guidance helps organizations assess whether services fall within covered situations and where related Medicare manual provisions apply.

Article Sections

1. General

   Introduces the Medicare coverage framework for heart transplantation and the facility approval context referenced by the policy.

2. Exceptions

   Outlines the types of limited exception requests discussed for transplant facilities and the general organizational requirements referenced by the policy.

3. Pediatric Hospitals

   Describes coverage considerations for pediatric heart transplant programs and the approval context for specialized hospital arrangements.

4. Follow-up Care

   Addresses post-transplant follow-up services and the related Medicare manual reference for additional coverage guidance.

5. Immunosuppressive Drugs

   Points to related Medicare manual references for drug and biological claims guidance connected to transplant care.

6. Artificial Hearts

   Summarizes Medicare coverage discussion for artificial heart use and related ventricular assist device references.