Cpt 33249

dcarr

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Does anyone understand the criteria listed in NCD #100-3 Section 20.4 related to implantable automatice defibrillators? I have read it several times, called WPS with no success for explanation, and still am very confused. I have several Medicare denials to work for possible appeals but do not understand what Dxs are actually valid for this procedure. Any help would be appreciated to clarify and condense this NCD.
 

Lisa Bledsoe

True Blue
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I have had this issue before...is it possible that you need to add modifier -Q0 to the procedure? You have to make sure that the facility in which the device was placed has logged the number of the device into the national registry. Q0 is not just for clinical research studies...it indicates that the device is registered into a national data base. You may even have to get that registry number and enter it in (I think) box 19 or the electronic equivalent. That's what I have been told and the way I understand it... Anyone else have any suggestions?
 
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