Reimbursement and
Coding

Medicare coding and payment guide for CentriMag and other acute mechanical circulatory support products

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

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

Provides Medicare guidance on coverage when the procedure is performed in a location other than a hospital.

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.

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.

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.

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

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