Cardiology Coding Alert

Question: Has there been any update on Medicare’s proposed pacemaker coverage for symptomatic bradycardia?

Pennsylvania Subscriber

Answer: In line with its proposed decision memo, Medicare has decided “the following indications are covered for implanted permanent single chamber or dual chamber cardiac pacemakers”:

·         “Documented non-reversible symptomatic bradycardia due to sinus node dysfunction”

·         “Documented non-reversible symptomatic bradycardia due to second degree and/or third degree atrioventricular block.”

As stated above, the indications include that the bradycardia is symptomatic. “Symptoms of bradycardia are symptoms that can be directly attributable to a heart rate less than 60 beats per minute (for example: syncope, seizures, congestive heart failure, dizziness, or confusion),” the decision memo states.

You can read the decision memo online at www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=267.