WATCHMAN™ Left Atrial Appendage Closure (LAAC) Device

Boston Scientific’s GuidePoint Reimbursement Resources are designed to specifically assist physician and hospital providers to navigate through the coding, coverage, and payment environment for new and innovative technologies such as the WATCHMAN LAAC Device.

On February 8, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a final decision memo supporting the national coverage determination (NCD) for percutaneous LAAC therapy when specific conditions are met.  This major milestone provides appropriate and uniform coverage for Medicare beneficiaries that for the most part are consistent with the WATCHMAN FDA label.  Our GuidePoint Reimbursement Resources have been updated to reflect the positive NCD to assist physicians and hospitals in seeking coverage and payment consideration of WATCHMAN implants on a case-by-case basis from private payers and provide additional information on the NCD.

  • Mar 29, 2016 2016 WATCHMAN Physician Category III Code Frequently Asked Questions (FAQ)

    This FAQ provides an overview to physicians of how to report WATCHMAN implants and how to benchmark equivalent work units for reporting the WATCHMAN procedure for payer coverage and payment consideration. PDF, 385.0 KB

  • Oct 01, 2015 Hospital Documentation Guide

    This guide stresses the importance of documentation in capturing the appropriate acuity level for patients considered WATCHMAN candidates. It helps provide an overview of the common complications and comorbidities that assist with the MS-DRG assignment based on patient medical appropriateness. PDF, 378.0 KB

  • Oct 01, 2015 Hospital Charging Practices

    This guide provides education to hospitals on the importance of appropriate charging practices for high cost implantable devices such as the WATCHMAN LAAC Device. PDF, 280.0 KB

  • Feb 22, 2016 WATCHMAN Prior Authorization and Crosswalk Template

    This template assists providers in customizing prior authorization requests for WATCHMAN coverage from private payers by referencing the NCD for percutaneous LAAC therapy. Prior authorization is recommended for WATCHMAN implants for case-by-case consideration by payers. Note that traditional Medicare does not offer prior authorization DOCX, 50.0 KB

  • Feb 22, 2016 Sample Appeal Letter for the WATCHMAN™ Left Atrial Appendage Closure (LAAC) Procedure

    Template to assist providers with appealing denials by utilizing the criteria of the NCD for percutaneous LAAC therapy in referencing patient’s eligibility. DOCX, 44.0 KB

  • Feb 24, 2016 2016 Rhythm Management Billing and Coding Guide

    PDF, 8.0 MB

  • Mar 11, 2016 2016 WATCHMAN™ Reimursement Guide

    This comprehensive guide provides an overview of the coding, coverage and payment landscape for the WATCHMAN system. PDF, 598.0 KB

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