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Our understanding as a department, prior to the institution of the new LAA exclusion code 33268, was that if an LAA clip was placed during a CABG, there still needed to be medical necessity documented for the placement of the clip in order to bill the 33268. Our auditing team is now telling us that because there is no LCD that we can bill it, even though there is no documentation of active A-Fib, or history of A-Fib. Is this correct? For years, thoracic surgeons have been placing the LAA clip during CABG with the understanding that prophylactic placement was not covered. Is that not the case anymore? All the documentation that I find indicates that LAA performed during other cardiac procedures is used to minimize the risk of stroke in patients with A-Fib. I am not understanding why we would bill it, if A-fib is not a documented diagnosis. Thank you.