Reimbursement and Coding


Find reimbursement resources, including coding guides, links to Medicare Coverage Determinations, on-demand webinars, and frequently asked questions for products used to conduct electrophysiology procedures.


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

Coding Guides and C-Codes

  • Medicare coding and payment guide for EP services, including catheter ablation.

  • This resource provides coding and reimbursement information as it relates to the 2022 ICE (Intracardiac echocardiography) add-on coding update and its impacts on Electrophysiology, Heart Failure, Cardiac Rhythm Management, and Structural Heart procedure codes.

  • Current list of reimbursement Healthcare Procedural Coding System (HCPCS) Device Category C-codes

    Printable form for easy CPT‡ coding reference

  • Printable form for easy CPT coding reference

  • This toolkit provides suggested instruction and summary of the United Healthcare guidelines for facilitating their prior authorization requirements. It is not an endorsed resource of United Healthcare as providers are highly encouraged to review the United Healthcare policy and requirements for prior authorization and medical guidelines.

  • Download this checklist for submitting prior authorization requests for your patient. The checklist includes a summary of the information used to process prior authorization requests for Atrial Fibrillation.

  • Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior authorization request for Atrial Fibrillation. Physicians should customize the letter based on the patient's medical history and diagnosis and to be consistent with any specific prior authorization requirements from the health plan.

  • 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.

  • 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.


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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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