CMS Proposes Adding Coverage to MRI NCD

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  • April 29, 2011
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The Centers for Medicare & Medicaid Services (CMS) announced April 25 in a proposed decision memo that there is sufficient evidence to conclude that magnetic resonance imaging (MRI) improves health outcomes for Medicare beneficiaries with implanted permanent pacemakers (PMs).
CMS is proposing to change the language in section 220.2.C.1 of the NCD Manual to remove the contraindication for Medicare coverage of MRI in beneficiaries with implanted PMs.
Aside from an exception for MRI furnished in approved clinical studies of implanted pacemakers and implantable cardioverter defibrillators (ICDs) under the Coverage with Evidence Development (CED) paradigm, MRI is non-covered for patients who have implanted cardiac pacemakers. But a new device said to be the first pacemaker for use in an MRI environment led CMS to reconsider its NCD for MRI.
CMS posted a proposed decision memo on the Medicare Coverage Database website after a 30-day public comment period, which ended April 2.

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