tci Medicare Compliance & Reimbursement - 2003 Issue 40

Coverage: COVERAGE EXPANDS,PAY INCREASES FOR VADs

VAD facilities will have to meet accreditation standards.Hospitals that perform heart transplants now have more opportunities to collect Medicare reimbursement for ventricular assist devices. In an Oct. 1 decision memo (CAG 00119N), the Centers for Medicare & Medicaid Services says it plans to expand coverage for VADs - and increase reimbursement for the procedure. Currently, VADs - mechanical pumps that perform some of the functions of a damaged heart - are only covered as a bridge to heart transplant or when implanted after open-heart surgery. Under the new coverage policy, VADs will become a "destination therapy" - a...

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