Cardiac Rhythm Management Resources for Medical Reimbursement | Abbott
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Cardiac Rhythm Management

Find reimbursement resources, including coding guides, links to Medicare Coverage Determinations, on-demand webinars, and frequently asked questions pertaining to Abbott cardiac rhythm management devices.

 

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Coding Guides and Resources

AVEIR™ VR Leadless Pacemaker Coding Guide

Find Medicare coding and national payment rates for the AVEIR VR Leadless Pacemaker.

AVEIR VR Leadless Pacemaker FAQ

See answers to frequently asked questions regarding the reimursement landscape for AVEIR VR Leadless Pacemaker.

Insertable Cardiac Monitors (ICM) Coding Guide

Find Medicare coding and national payment rates for Insertable/Implantable Cardiac Monitors (ICM).

Implantable Cardiac Defibrillator (ICD) Coding Guide

Find Medicare coding and national payment rates for implantable cardioverter defibrillators (ICDs).

Cardiac Resynchronization Therapy (CRT) Coding Guide

Find Medicare coding and national payment rates for cardiac resynchronization therapies (CRT).

Cardiac Device Monitoring Coding Guide

Find Medicare coding and national payment rates for cardiac device monitoring.

Transvenous Pacemaker Coding Guide

Find Medicare coding and national payment rates for transvenous pacemakers.

Physician Non-Facility Device Monitoring Rates by Location

Find Medicare coding and payment rates, by location, for cardiac device monitoring in physician offices (non-facilities).

Cardiac Device Monitoring: CPT Codes and Common Questions

Find a summary of Medicare coding and answers to Frequently Asked Questions for device monitoring for Pacemakers, Implantable Cardioverter Defibrillators (ICD), Cardiac Resynchronization Therapy (CRT) and Insertable/Implantable Cardiac Monitors (ICM).

Magnetic Resonance Imaging (MRI) in Medicare Patients with Cardiovascular Implantable Electronic Devices (CIEDs)

Find answers to Frequently Asked Questions about Medicare coverage of MRIs for patients with pacemakers, ICDs and CRT devices.

Insertable Cardiac Monitors (ICM) In Office Readiness Checklist

Use this printable form to assess your physician office’s readiness to begin implanting and monitoring ICMs.

HCPCS Device Category C-codes Guide

Current reimbursement Healthcare Procedural Coding System (HCPCS) Device Category C-codes.

Centers for Medicare and Medicaid (CMS)

Pacemaker NCD

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

Implantable Cardioverter Defibrillators (ICDs) NCD

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

Implantable Cardioverter Defibrillator National Coverage Determination FAQs

Coverage considerations and Frequently Asked Questions regarding ICDs.

Webinars

2021 Reimbursement Changes for Insertable Cardiac Monitors (ICMs)

This one-hour webcast addresses coding and payment for Insertable/Implantable Cardiac Monitors (ICMs). First, we provide an overview of ICM technology and the insertion process. Then we discuss 2021 coverage, coding and payment for ICMs. Finally, we review remote monitoring and how to appropriately report common patient scenarios to Medicare.

Clinical Experiences with Remote Monitoring: Guidance for Patient-Centric Care and Clinic Reimbursement

Remote monitoring is critical to ensure appropriate follow-up care for patients implanted with an Abbott cardiac device. This one-hour webcast provides an educational review of remote monitoring for patients with implanted pacemakers, cardiac resynchronization therapy devices, implantable cardioverter defibrillators and implantable cardiac monitors.

2023 AVEIR VR Leadless Pacemaker Webinar

This webinar provides an overview of leadless pacemaker reimbursement, including information on the Single Chamber Leadless Pacemaker device. The session will address coding, reimbursement and national indications for coverage. Recent Medicare Payment Policies including the FY 2023 Medicare Inpatient Prospective Payment System (IPPS), Medicare Physician Fee Schedule (PFS), and Medicare Outpatient Prospective Payment System (OPPS) will also be discussed.

Prior Authorization and Appeal Tool Kits

Abbott offers this Prior Authorization and Appeal Tool Kits for use by physicians and their offices when seeking prior authorization or appealing denials of coverage. This comprehensive tool kit includes information to assist your office in submitting coverage requests for patients indicated for a leadless pacemaker. Download the guides and the accompanying templates using the links below.

Prior Authorization Checklist for Implanting Physicians

Download this document as a reference guide when submitting Prior Authorizations.

Sample Letter of Medical Necessity

Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior Authorization request for leadless pacemaker device implants. Physicians should customize the letter based on the patient's actual medical history and diagnosis and to be consistent with any specific prior authorization requirements.

Sample Letter of Appeal

Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a denial of coverage for leadless pacemaker device implant procedures. Physicians should customize the letter based on the patient's actual medical history and diagnosis, and to be consistent with any specific appeal requirements.

Sample Letter of Appeal for Claims Denial

Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a claim denial for leadless pacemaker device implant procedures. Physicians should customize the letter based on the patient's actual medical history and diagnosis, and to be consistent with any specific appeal requirements.

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HE&R Disclaimer

This material 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 is not intended to and does not constitute a representation or guarantee of reimbursement, payment, or charge, or that reimbursement or other payment will be received. It is not intended to increase or maximize payment by any payer. Similarly, nothing in this document should be viewed as instructions for selecting any particular code, and Abbott does not advocate or warrant the appropriateness of the use of any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and 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, coding, or reimbursement specialist for any questions related to coding, billing, reimbursement or any related issues. This material reproduces information for reference purposes only. It is not provided or authorized for marketing use.

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