Basics of ReimbursementCRM and EP C-Codes
Cardiac Rhythm Management and Electrophysiology C-Codes for Medical Devices
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Reimbursement
Boston Scientific Cardiac Rhythm Management (CRM) offers resources for hospitals, physicians, clinicians, and reimbursement professionals seeking a better understanding of reimbursement for CRM and Electrophysiology procedures. For questions on coding, coverage, and reimbursement for CRM and EP therapies, contact our reimbursement customer support line at 1.800.CARDIAC (227.3422).
Latest News and Updates
Private Payer CRT-D Prior Authorization Template
Coverage for CRT-D therapy varies among private payers and many have processes in place for prior authorization. Boston Scientific offers a CRT-D prior authorization template available for physician use. To obtain a copy of a prior authorization template please contact our reimbursement support line by calling 1.800.CARDIAC (227.3422) and ask for the Reimbursement Customer Support Line
Medicare and Private Payer Coverage for CRT-D
Coverage for CRT-D therapy varies among the Centers for Medicare & Medicaid Services (CMS) and private health plans. This resource includes information on CMS’ coverage policies and recent coverage expansion by many private health plans for CRT-Ds from Class III and IV to include Class II patients with mild heart failure. CRV-24308-AA
CMS Payment, 2012 Medicare Final Hospital Inpatient MS-DRG Payment Rates
Medicare FY2012 Inpatient Final Rule highlights including National Average Payment for select Interventional Cardiology, Peripheral Interventions, Cardiac Rhythm Management, and Electrophysiology MS-DRGs. Overall rates are relatively stable. This Final Rule will go into effect October 1, 2011. CRV-17207-AA
CY2012 Final HOPPS, ASC and Physician Rule Summary
Summary and impact on selected procedures of the Medicare 2012 Final Hospital Outpatient Prospective Payment System (HOPPS) Ambulatory Surgical Centers (ASC) and Physician Fee Schedule (PFS). CRV-37910-AA
Device Monitoring Codes
View resources for CPT codes and payment rates related to cardiac device monitoring, including an implantable cardiovascular Monitor (ICM) code that physicians can use when monitoring the cardiac health care of their patients. Note that all cardiac device monitoring codes changed as of January 1, 2009.
FAQ on Device Monitoring Procedures & Codes
Questions and answers to help understand the code changes of 2009.
Quick Reference Guide for CRM Device Monitoring Procedures
Summary of changes to the device monitoring codes that includes a table highlighting base payment rates, code descriptors, and frequency guidelines for each CPT code.
Cost-Effectiveness of Cardiac Resynchronization Therapy in the COMPANION Trial
JACC article that examines the cost effectiveness of cardiac resynchronization therapy (CRT) in the COMPANION trial population.
Boston Scientific Cardiac Rhythm Management (CRM) offers resources for hospitals, physicians, clinicians, and reimbursement professionals seeking a better understanding of reimbursement for CRM and Electrophysiology procedures. For questions on coding, coverage, and reimbursement for CRM and EP therapies, contact our reimbursement customer support line at 1.800.CARDIAC (227.3422).
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