Reimbursement and Coding

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

Reimbursement for Common Pacemaker Procedures

In this one-hour webinar, reimbursement expert Erin Spengeman presents a framework for coding pacemaker procedures and explains how to apply the framework to six different patient scenarios. She also outlines Medicare coverage criteria and 2021 Medicare payment amounts for pacemaker procedures.

2020 ICM Insertion/Remote Monitoring Reimbursement Update

This 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 2020 coverage, coding and payment for ICMs, including the 2020 changes to ICM remote monitoring coding. Finally, we review common patient scenarios and how to appropriately report them to Medicare.

2019/2020 Reimbursement Update: Cardiac Rhythm Management (CRM)

This one-hour webcast addresses coding, payment and national coverage indications for Pacemakers, Implantable Cardioverter Defibrillators (ICDs), and Cardiac Resynchronization Therapy (CRT-P/CRT-D). It provides an overview of payment under Medicare’s FY 2020 Inpatient Prospective Payment System (IPPS) and Medicare’s FY 2019 Physician Fee Schedule (PFS), Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment system. The program also includes common patient scenarios and how to appropriately report to Medicare.

Health Economic Summit Episode 1 - Cardiac Resynchronization Therapy (CRT)

This program is a one-hour webcast facilitated by cardiologist Dr. John Rogers. Economic and product specific topics related to CRT will be addressed including patient outcomes, Medicare reimbursement, and the economics of heart failure.

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.

HE&R Disclaimer

This document 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.