Billing and Coding: Implantable Automatic Defibrillators - R2 - Effective October 01, 2019

The coverage requirements for the Billing and Coding: Implantable Automatic Defibrillators National Coverage Determination (NCD) have been revised and published under contract numbers: 01112 (NCA), 01182 (SCA) and 01212 (AS, GU, HI, NMI), and 01312 (NV).

NCD: Billing and Coding: Implantable Automatic Defibrillators and NCD Number 20.4
Effective Date: October 01, 2019
Summary of Article Changes: Noridian made the following updates to this article.

  • Added a hyphen between decision and making throughout the Article Text
  • Added the statement “NOTE: Effective February 15, 2018, coverage policy is no longer contingent on participation in a trial/study/registry. Therefore, claims with DOS on an after February 15, 2018, no longer require trial-related coding” to the Article Text.
  • Clarified the statement in Paragraph 1 in the ICD-10 Codes that Support Medical Necessity section to indicate the diagnosis codes are for both inpatient and outpatient services and that the applicable secondary diagnoses for the codes listed are listed in the Article Text.
  • Added the ICD-10-PCS insertion and removal codes in the ICD-10-PCS Codes Section and noted the removal code 02PAXMZ is valid until October 31, 2021.

Visit the Noridian National Coverage Determination (NCD) webpage to view the locally hosted NCD coverage requirement articles.

To view a complete list of CMS NCDs, visit the National Coverage Determinations (NCDs) Alphabetical Index.

            Last Updated Tue, 03 Aug 2021 14:41:04 +0000