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Coding & Coverage
Coverage policies and coding resources for Cardiac Rhythm Management and Electrophysiology procedures.
Medicare and Private Payer Coverage for CRT-D
Coverage for CRT-D therapy varies among the Centers for Medicare & Medicaid Services (CMS) and private health plans. This resource includes information on CMS’ coverage policies and recent coverage expansion by many private health plans for CRT-Ds from Class III and IV to include Class II patients with mild heart failure. CRV-24308-AA
IMPORTANT NOTE:
Due to legislative uncertainty related to Medicare’s 2012 Physician Fee Schedule (PFS), physician rates provided in our guides reflect 2012 National Average Medicare physician rates calculated using the 2012 conversion factor of $34.0376. All rates are subject to change and do not reflect the projected 2012 SGR reduction of 27.4% in physician rates.
The following documents are subject to change and may not reflect current rates. We will continue to update these documents as the latest information on coverage policies and coding resources for Cardiac Rhythm Management and Electrophysiology procedures becomes available.
Coverage
2012 GuidePoint Billing and Coding Guide
Quickly find coding and billing information, including scenarios specific to CRM and EP procedures. CRM-33504-AA JAN 2012
2012 Procedural Payment Guide
Provides facility and physician payment information for cardiology, rhythm and peripheral interventional procedures. CRV-38110-AA JAN2012
C-Codes
Cardiac Rhythm Management and Electrophysiology C-Codes for Medical Devices
The Center for Medicare and Medicaid Services (CMS) requires hospitals to report all device-related category codes (C-codes) on Medicare claims when medical devices are used in procedures performed in the outpatient setting. This document provides a list of all C-codes that pertain to Boston Scientific CRM and EP products. CRM-33504-AA JAN 2012
Coding
Commonly Billed Procedure Codes for CRT-P
A brief description of the implant procedure along with commonly billed procedure codes for CRT-P procedures.
Commonly Billed Procedure Codes for ICD
A brief description of the implant procedure along with commonly billed procedure codes for ICD procedures.
Commonly Billed Procedure Codes for CRT-D
A brief description of the implant procedure along with commonly billed procedure codes for CRT-D procedures.
Commonly Billed Procedure Codes for Pacemakers
A brief description of the implant procedure along with commonly billed procedure codes for Pacemaker procedures.
Commonly Billed Device Monitoring Procedures
An overview of the commonly billed device monitoring procedures.
Commonly Billed Procedure Codes for Intracardiac EP Study
A brief description of the EP Study procedure along with commonly billed procedure codes for Intracardiac EP Study procedures.
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Reimbursement Support
Ask your CRM and EP reimbursement questions by calling 1.800.CARDIAC (227.3422) and ask for the Reimbursement Customer Support Line
CRM10-1525-0112