1
CARDIOVASCULAR
hamburger

Structural Heart

Find reimbursement resources, including coding guides, links to Medicare Coverage Determinations, on-demand webinars, and frequently asked questions for products used to treat structural heart conditions.

 

WE'RE HERE TO HELP

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

 

Structural Interventions and Heart Valve Replacement, Including PFO Closure

Coding Guides and Resources

Structural Heart and Valves Coding Guide

Medicare coding and payment guide for for the surgical heart valves

Amplatzer Piccolo™ Occluder Coding and Reimbursement Guide

Medicare coding and payment guide for Patent Ductus Arteriosus (PDA) closure procedures

PFO Letter of Medical Necessity

Template to be considered for prior authorization by physicians

PFO Letter of Appeal

Template to be considered when requesting reconsideration of a denied claim or pre-authorization

Patent Foramen Ovale Closure with the Amplatzer™ PFO Occluder for Secondary Stroke Reduction of Risk in Patients with Cryptogenic Stroke: Summary of Clinical Evidence

Clinical study results combined into one document

Clinical Documentation Checklist: Diagnosis of Cryptogenic Ischemic Stroke

Use this printable form to assist with diagnosis of this condition

Centers for Medicare and Medicaid Services (CMS)

CMS Physician Fee Schedule Prospectus

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.

CMS Inpatient Reimbursement Prospectus

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.

CMS Outpatient Reimbursement Prospectus

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.

Medicare Local Coverage Determinations (LCDs)

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.

Medicare National Coverage Determinations (NCDs)

Developed through an evidence-based process, check here for a list of CMS policies that provide coverage for all Medicare beneficiaries.

Medicare Learning Network (MLN) Matters Articles

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

National Correct Coding Initiatives Edits

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

  • Customer Service
  • Cardiovascular Products
  • Manuals & Technical Resources

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.

MAT-2008669 v1.0

DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.

False
accessibility
© 2019 Abbott. All Rights Reserved. Please read the Legal Notice for further details.

Unless otherwise specified, all product and service names appearing in this Internet site are trademarks owned by or licensed to Abbott, its subsidiaries or affiliates. No use of any Abbott trademark, trade name, or trade dress in this site may be made without the prior written authorization of Abbott, except to identify the product or services of the company.

accessibility

DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.