tci Medicare Compliance & Reimbursement - 2004 Issue 32

Coverage: Keep Up With Cardiac Implant Guidelines

Here's what Medicare says about reimbursement for pacemaker implantation.If providers weren't clear on when they'd get paid for pacemakers - and when they wouldn't - the Centers for Medicare & Medicaid Services has cleared the fog with its recent national coverage decision (NCD). You can now review a list of what diagnoses justify the implantation procedure. After lengthy review, CMS determined that "pacemaker implantation is no longer considered routinely harmful or an experimental procedure." Pacemakers themselves have been covered as prosthetic devices under the Medicare program, but until this year the only guidance available on medical...

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