Reimbursement and Coding

Cardiac Rhythm Management

Reimbursement and Coding

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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Contact our Health Economics and Reimbursement Department for additional information or assistance. 

Coding Guides and Resources

Centers for Medicare and Medicaid (CMS)

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

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

Webinars

  • Discover the latest on-demand webinar brought to you by the HE&R team. This is your chance to learn about ICM coding and reimbursement payments for Assert-IQ™ ICM and provide continuing education to your customers. 

  • 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.

  • 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.

 

Leadless Pacemakers, Single Chamber

  • Download this document as a reference guide when submitting Prior Authorizations for single chamber leadless pacemakers.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior Authorization request for single chamber 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.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a denial of coverage for single chamber 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.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a claim denial for single chamber 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.

Leadless Pacemakers, Dual Chamber

  • Download this document as a reference guide when submitting Prior Authorizations for dual chamber leadless Pacemakers.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior authorization request for dual chamber 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.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a denial of coverage for dual chamber 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.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a claim denial for dual chamber 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.

  • CED Policy Information for leadless pacemaker procedures for all Medicare beneficiaries which include Traditional Medicare Fee for Service and Medicare Advantage

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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. Abbott makes no express or implied warranty or guarantee that the list of codes and narratives in this document is complete or error-free. 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 is subject to change without notice. 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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