CARDIOVASCULAR
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Reimbursement & Coding

We have compiled the HF management product coding documents and references relevant for the HeartMate II™ LVAD. Print, save or bookmark these resources for quick reference. In addition, we hold webcasts addressing reimbursement questions. Contact our healthcare economics department for more information.

Coding Guides and Resources

Access coding documents, health care economics insights, FAQs and other educational references for the HeartMate II LVAD and other mechanical circulatory support products:

Mechanical Circulatory Support (MCS) Coding Guide

Mechanical Circulatory Support (MCS) FAQ Guide

HCPCS Device Category C-codes

This document provides a current list of reimbursement C-codes.

Common CPT Code Modifiers

This list of common CPT code modifiers is printable for easy coding reference.

Webinars

2021 Mechanical Circulatory Support (MCS) Medicare Payment update focused on HeartMate Left Ventricular Assist Devices (LVAD)

Registration is required for this webinar, which addresses the FY 2021 Medicare Inpatient Prospective Payment System (IPPS), CY 2021 Medicare Physician Fee Schedule (PFS) payment and policy updates for HeartMate LVAD.

National Coverage Determinations From Medicare and Medicaid

National Coverage Determination (NCD) for Ventricular Assist Devices

Developed through an evidence-based process, this policy provides details on required medical criteria that must be met for coverage of Medicare beneficiaries.

Centers for Medicare and Medicaid Services (CMS)

CMS Physician Fee Schedule Prospectus

This guide includes Medicare Physician Payment Rates for cardiovascular procedures. For more detailed information, please refer to the CY Physician Fee Schedule Final Rule on the CMS website.

CMS Inpatient Reimbursement Prospectus

This guide provides a summary of the Medicare Hospital Inpatient Prospective Payment System (IPPS). It includes information on the Readmission Reductions Program, Value Based Purchasing, and Hospital Inpatient Reimbursement Rates for select cardiovascular DRGs. For more detailed information, please refer to the FY IPPS Final Rule on the CMS website.

CMS Outpatient Reimbursement Prospectus

This guide provides a summary of the Medicare Hospital Outpatient Prospective Payment System (OPPS) Update. It includes updates to the Comprehensive APC Policy, Site Neutral Payments, Device Intensive Procedures, the Transitional Pass-Through Payment Policy and Hospital Outpatient Reimbursement Rates for select cardiovascular APCs. For more detailed information, please refer to the CY OPPS Final Rule on the CMS website.

Medicare Local Coverage Determinations (LCDs)

In the absence of a national coverage policy, an item or service may be covered at a local basis. Check here for a list of CMS policies that provide Medicare beneficiaries coverage in certain locations across the country.

Medicare Learning Network (MLN) Matters Articles

Focusing on coverage, billing and payment rules for specific provider types, these articles explain national Medicare policy in an easy-to-understand format.

National Correct Coding Initiatives Edits

Developed by CMS, the initiative promotes correct coding methodologies to control improper coding leading to inappropriate payment.

*Disclaimer: This webpage and the information contained herein is for general information purposes only and is not intended, and does not constitute, legal reimbursement, business, clinical or other advice. Furthermore, it does not constitute a representation or guarantee of reimbursement, and it is not intended to increase or maximize payment by any payer. Nothing in this document should be construed as a guarantee by Abbott regarding reimbursement or payment amounts, or that reimbursement or other payment will be received. The ultimate responsibility for obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all claims submitted to third-party payers. In addition, the customer should note that laws, regulations, and coverage policies are complex and are updated frequently, and, therefore, the customer should check with its local carriers or intermediaries often and should consult with legal counsel or a financial or reimbursement specialist for any questions related to billing, reimbursement or any related issue. This update reproduces information for reference purposes only. It is not provided or authorized for marketing use.

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DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.