CMS Delays Implementing Permanent Pacemakers NCD

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  • September 11, 2015
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The Centers for Medicare & Medicaid Services (CMS) announced in the Sept. 10 issue of MLN Connects® Provider eNews that it is temporarily delaying implementation of the National Coverage Determination (NCD) for Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (20.8.3).
CMS issued a final decision memorandum in 2013 stating that single or dual chamber, permanent, cardiac pacemakers are reasonable and necessary for the treatment of non-reversible symptomatic bradycardia due to sinus node dysfunction and second- and/or third-degree atrioventricular block. Earlier this year, CMS released Change Request (CR) 9078 transmittals 179 and 3204, implementing the NCD for claims with dates of service on and after Aug. 13, 2013, for those beneficiaries who meet specific coverage criteria.
CMS now says all editing and decisions on coverage relative to CR 9078 will be made at the local Medicare administrative contractor (MAC) level, until further notice.

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Renee Dustman, BS, AAPC MACRA Proficient, is managing editor - content & editorial at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. Follow her on Twitter @dustman_aapc.

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