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Cost of ICDs
CMS Expands Coverage for ICDs
Additional Information
CMS Expands Coverage for ICDs
On January 27, 2005 the Centers for Medicare and Medicaid Services (CMS) issued its national coverage decision for expanded ICD coverage.
Click here to view the decision memorandum for expanded coverage for Implantable Cardioverter Defibrillators.
On October 27, 2005 CMS announced their collaboration with the American College of Cardiology to collect data nationwide to help learn more about the use of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death among Medicare beneficiaries. As a result of the contract, the American College of Cardiology’s National Cardiovascular data Registry’s (ACC-NCDR) ICD Registry ™ became the new repository of information from hospitals effective April 1, 2006. The registry was created by a partnership between the American College of Cardiology and the Heart Rhythm Society, and has support from the ICD manufacturing industry, private health plans and payers, and hospital groups.
The documents below may assist you in providing this life saving therapy to your primary prevention patients as a result of the expansion of CMS (Medicare) ICD coverage.
- The CMS Press release announcing the new ICD registry effective April 1, 2006. This press release can be located at http://new.cms.hhs.gov/apps/media/press/release.asp?Counter=1698
- ICD Registry Primary Prevention Questionnaire. This questionnaire may be helpful when determining whether a CMS patient is primary or secondary prevention. CMS and HRS reviewed this form but this form is not a required CMS form. Here is the new questionnaire.
- ACC-NCDR® ICD Registry ™ V1.08 Data Collection Form
IMPLANT effective after close of business on 5-5-2006 can be found at http://www.accncdr.com/WebNCDR/ICD/ELEMENTS.ASP
The data dictionary definitions can be found at
http://www.accncdr.com/WebNCDR/ICD/ELEMENTS.ASPX
- ICD Registry ™ - Frequently Asked Questions can be found at http://www.accncdr.com/webncdr/icd/cmsicdmandate_faq.aspx
CMS Frequently Asked Questions can be found at http://www.cms.hhs.gov/CoverageGenInfo/Downloads/icd1.pdf
Additional Information
ICD-9-CM Diagnosis Codes
When coding the diagnoses of primary prevention patients undergoing an ICD implant, it is not possible to code VT or VF because they have not experienced these arrhythmias. Instead it is necessary to code the risk factors they are experiencing, for example heart failure. Attached is a list of codes developed by an expert outside consultant for your consideration.
These coding suggestions do not replace seeking coding advice from the payer and/or your own coding staff. The ultimate responsibility for correct coding lies with the provider of services. All diagnosis and procedure codes must be supported by clear documentation within the medical record.
Last updated: February 19, 2007 |
