Cardiology Coding Alert

Reader Question:

Study Medicare Leadless Pacemaker Coverage

Question: Where can I find Medicare’s coverage rules for leadless pacemakers?

Pennsylvania Subscriber

Answer: Medicare recently posted a decision memo at this site: www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=285. It should be available in the National Coverage Determinations manual soon.

CMS covers leadless pacemakers through Coverage with Evidence Development (CED), meaning the service must be part of a CMS-approved study for Medicare to cover the service.

You’ll find the codes for leadless pacemakers in Category III, 0387T-0391T.