tci Medicare Compliance & Reimbursement - 2004 Issue 17

Hospitals: Pacemaker Coverage Expands

CMS memo: "Pacemaker implantation is no longer an experimental procedure."Good news for providers involved in pacemaker implantation procedures.After years of pressure to reconsider its stance, the Centers for Medicare & Medicaid Services has finally succumbed, saying it intends to update cardiac pacemaker coverage for the first time since 1985.The implantation of cardiac pacemakers is officially deemed to be a reasonable and necessary procedure -- no longer an experimental one -- with minimal risk and a time-tested technique, thereby meeting the requirements for Medicare coverage.However, victory is limited. Whether the pacemaker itself is reasonable and necessary...

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