Cardiology Coding Alert
Delay in Pacemaker NCD Leaves Decisions to Your Local MAC
CMS announced a temporary delay in implementing National Coverage Determination (NCD) 20.8.3, “Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers.”
The NCD determined single and dual chamber cardiac pacemakers “are reasonable and necessary for the treatment of non-reversible symptomatic bradycardia due to sinus node dysfunction and second and/or third degree atrioventricular block.” The related Transmittal is Transmittal 3204, CR 9078 (www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3204CP.pdf). The effective date was Aug. 13, 2013, but the implementation date was July 6, 2015.
The delay means “that all editing and decisions on coverage relative to CR 9078 will be made at the local Medicare Administrative Contractor (MAC) level until further CMS notice. CMS will advise you of the new implementation date in the near future.”
Resource: The announcement is in the Sept. 10, 2015, MLN Connects® Provider eNews under Claims, Pricers, and Codes (www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2015-09-10-eNews.html).
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