Cardiology Coding Alert

Question: Is it true that Medicare is now covering MRI scans for patients with the new MRI-safe pacemaker?

Florida Subscriber

Answer: As of publication time, the answer to that question is, "Not exactly." Medicare announced it will cover MRI scans for patients with implanted pacemakers and cardioverter defibrillators, but only if those patients are enrolled in CMS-approved clinical studies involving MRI safety and meet multiple requirements set forth in the national coverage determination (NCD) available at www.cms.gov/Transmittals/downloads/R132NCD.pdf.

This coverage change became effective Feb. 24, 2011. You can find the MLN Matters article at www.cms.gov/MLNMattersArticles/downloads/MM7296.pdf.

Confusion clarified: CMS has indicated the above coverage decision was made independent of the approval of Medtronic's Revo MRI SureScan, a pacemaker the FDA approved for use with MRI. CMS said the FDA "approval came after the close of public comment period on our recent reconsideration of the MRI NCD (CAG- 00399R2, published February 24, 2011) and too late for CMS to adequately review the evidence and issue a final decision before the statutory due date."

Now CMS has reopened the investigation to consider whether MRIs should be covered for patients with FDAapproved MRI-safe devices.

Resource: You can search open and closed national coverage analyses at www.cms.gov/medicare-coveragedatabase/indexes/national-and-local-indexes.aspx.