Reimbursement In Brief

CMS posted a proposed decision memo May 29 stating that the existing clinical evidence supports coverage of implanted permanent single-chamber or dual-chamber cardiac pacemakers in patients with documented symptomatic bradycardia due to sinus node dysfunction or second degree and/or third degree atrioventricular block. The proposal would noncover 14 additional indications, including asymptomatic first-degree atrioventricular block and asymptomatic sinus bradycardia, based on findings of insufficient evidence that implanted cardiac pacemakers are reasonable and necessary for the conditions. CMS notes that symptoms of bradycardia are those that are directly attributable to a heart rate of less than 60 beats per minute, such as syncope, seizures, congestive heart failure, dizziness or confusion.

CMS opened the national coverage analysis in January in response to a letter from the Heart Rhythm Society and the...