Medicare Compliance & Reimbursement

Implantable defibrillators must be registered.

Medicare patients who receive an ICD or replacement ICD as a primary prevention of sudden cardiac death must be enrolled in a data collection system - otherwise, Medicare may not provide coverage for the procedure.

What to do: CMS has released an implantable cardioverter defibrillator abstraction (ICDA) tool - an electronic registry - that Medicare-participating hospitals can download. Physicians can use the tool solely for data collection. However, they must submit patient information to the system to satisfy Medicare's coverage requirement, CMS said in a Medlearn Matters article.

ICD patients who qualify for the registry include those with no history of an arrest or arrhythmia, the article says.

Medicare Part B claims for ICD implantation submitted on or after April 1, 2005 should include modifier -QR to signify the patient's enrollment in the registry. Although Part A lacks the equivalent of modifier -QR, CMS says it can still identify and review registry participation through other mechanisms.

You can download the tool by clicking on "ICDA Tools" at www.qnetexchange.org/icda. To read more, see www.cms.hhs.gov/medlearn/matters/mmarticles/2005/SE0517.pdf.