evekhm/cms_iom_500 huggingface dataset:
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Ellenbogen KA, Gilligan DM, Wood MA, Morillo C, Barold SS.  The pacemaker syndrome   a matter of definition. Am J Cardiol. 1997 May 1;79(9):1226-9.Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; Society of Thoracic Surgeons. ACC/AHA/HRS 2008 Guidelines for device-based therapy of cardiac rhythm abnormalities. Heart Rhythm. 2008 Jun;5(6):e1-62. doi: 10.1016/j.hrthm.2008.04.014. Epub 2008 May 21.Fleischmann KE, Orav EJ, Lamas GA, Mangione CM, Schron E, Lee KL, Goldman L.  Pacemaker implantation and quality of life in the Mode Selection Trial (MOST). Heart Rhythm. 2006 Jun;3(6):653-9. Epub 2006 Mar 13.Fored CM, Granath F, Gadler F, Blomqvist P, Rynder J, Linde C, Ekbom A, Rosenqvist M.  Atrial vs. dual-chamber cardiac pacing in sinus node disease: a register-based cohort study. Europace. 2008 Jul;10(7):825-31. doi: 10.1093/europace/eun118. Epub 2008 May 7.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Gillis AM, Russo AM, Ellenbogen KA, Swerdlow CD, Olshansky B, Al-Khatib SM, Beshai JF, McComb JM, Nielsen JC, Philpott JM, Shen WK; Heart Rhythm Society; American College of Cardiology Foundation. HRS/ACCF expert consensus statement on pacemaker device and mode selection. Developed in partnership between the Heart Rhythm Society (HRS) and the American College of Cardiology Foundation (ACCF) and in collaboration with the Society of Thoracic Surgeons. Heart Rhythm. 2012 Aug;9(8):1344-65. doi: 10.1016/j.hrthm.2012.06.026.Ginter JF, Loftis P.  Second-degree atrioventricular block.  J of the Am Academy of Physician Assistants. 2011 Feb 18.  http://www.jaapa.com/second-degree-atrioventricular-block/article/196593/.  Accessed:  04/10/2013.Greenspon AJ, Patel JD, Lau E, Ochoa JA, Frisch DR, Ho RT, Pavri BB, Kurtz SM.  Trends in permanent pacemaker implantation in the United States from 1993 to 2009: increasing complexity of patients and procedures.  J Am Coll Cardiol. 2012 Oct 16;60(16):1540-5. doi: 10.1016/j.jacc.2012.07.017. Epub 2012 Sep 19.Grenouilleau-Albertini A, Copie X, Mabo P, et al.  Single or dual-chamber pacemakers? The guidelines of the HAS.  Archives of Cardiovascular Diseases Supplements. 2010; 2: 61-74.Hansen JF, Meibom J.  The prognosis for patients with complete heart block treated with permanent pacemaker.  Acta Med Scand.  1974 May; 195(5):385-9.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Hansen JF, Meibom J.  The prognosis for patients with complete heart block treated with permanent pacemaker.  Acta Med Scand.  1974 May; 195(5):385-9.Healey JS, Toff WD, Lamas GA, Andersen HR, Thorpe KE, Ellenbogen KA, Lee KL, Skene AM, Schron EB, Skehan JD, Goldman L, Roberts RS, Camm AJ, Yusuf S, Connolly SJ.  Cardiovascular outcomes with atrial-based pacing compared with ventricular pacing: meta-analysis of randomized trials, using individual patient data. Circulation. 2006 Jul 4;114(1):11-7. Epub 2006 Jun 26.Horgan JH.  Cardiac pacing. Br Med J (Clin Res Ed). 1984 Jun 30;288(6435):1942-4.Johansson BW.  Longevity in complete heart block.  Ann NY Acad Sci. 1969 Oct 30;167(2):1031-7.Kaszala K, Kalahasty G, Ellenbogen KA. Cardiac pacing in the elderly. Am J Geriatr Cardiol. 2006 Mar-Apr;15(2):77-81.Kerr CR, Connolly SJ, Abdollah H, Roberts RS, Gent M, Yusuf S, Gillis AM, Tang AS, Talajic M, Klein GJ, Newman DM.  Canadian Trial of Physiological Pacing: Effects of physiological pacing during long-term follow-up. Circulation. 2004 Jan 27;109(3):357-62. Epub 2004 Jan 5.Lamas GA, Lee K, Sweeney M, Leon A, Yee R, Ellenbogen K, Greer S, Wilber D, Silverman R, Marinchak R, Bernstein R, Mittleman RS, Lieberman EH, Sullivan C, Zorn L, Flaker G, Schron E, Orav EJ, Goldman L.  The Mode Selection Trial (MOST) in sinus node dysfunction: design, rationale, and baseline characteristics of the first 1000 patients. Am Heart J. 2000 Oct;140(4):541-51.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Lamas GA, Lee KL, Sweeney MO, Silverman R, Leon A, Yee R, Marinchak RA, Flaker G, Schron E, Orav EJ, Hellkamp AS, Greer S, McAnulty J, Ellenbogen K, Ehlert F, Freedman RA, Estes NA 3rd, Greenspon A, Goldman L; Mode Selection Trial in Sinus-Node Dysfunction.  Ventricular pacing or dual-chamber pacing for sinus-node dysfunction.  N Engl J Med.  2002 Jun 13:346(24):1854-62.Lamas GA, Orav EJ, Stambler BS, Ellenbogen KA, Sgarbossa EB, Huang SK, Marinchak RA, Estes NA 3rd, Mitchell GF, Lieberman EH, Mangione CM, Goldman L.  Quality of life and clinical outcomes in elderly patients treated with ventricular pacing as compared with dual-chamber pacing.  Pacemaker Selection in the Elderly Investigators. N Engl J Med. 1998 Apr 16;338(16):1097-104.Mangrum JM, DiMarco JP.  The evaluation and management of bradycardia.  N Engl J Med. 2000 Mar 9;342(10):703-9.Modi S, Krahn A, Yee R.  Current concepts in pacing 2010-2011: the right and wrong way to pace.  Curr Treat Options Cardiovasc Med. 2011 Oct;13(5):370-84. doi: 10.1007/s11936-011-0137-6.Mller C, Cernin J, Glogar D, Laczkovics A, Mayr H, Scheibelhofer W, Schmidinger H, Schuster E, Sedlacek K, Kaliman J.  Survival rate and cause of death in patients with pacemakers: dependence on symptoms leading to pacemaker implantation.  Eur Heart J.  1988 Sep;9(9):1003-9.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Nielsen JC, Kristensen L, Andersen HR, Mortensen PT, Pedersen OL, Pedersen AK.  A randomized comparison of atrial and dual-chamber pacing in 177 consecutive patients with sick sinus syndrome: echocardiographic and clinical outcome. J Am Coll Cardiol. 2003 Aug 20;42(4):614-23.Nielsen JC, Thomsen PE, Hjberg S, Mller M, Vesterlund T, Dalsgaard D, Mortensen LS, Nielsen T, Asklund M, Friis EV, Christensen PD, Simonsen EH, Eriksen UH, Jensen GV, Svendsen JH, Toff WD, Healey JS, Andersen HR; DANPACE Investigators.  A comparison of single-lead atrial pacing with dual-chamber pacing in sick sinus syndrome. Eur Heart J. 2011 Mar;32(6):686-96. doi: 10.1093/eurheartj/ehr022. Epub 2011 Feb 7.Nowak B, Misselwitz B, Erdogan A, et al.  Do gender differences exist in pacemaker implantation? results of an obligatory external quality control program. Europace. 2010; 12: 210-5.Rosenqvist M, Nordlander R.  Survival in patients with permanent pacemakers.  Cardiol Clin.  1992 Nov;10(4):691-703.Silberbauer J, Veasey RA, Freemantle N, Arya A, Boodhoo L, Sulke N.  The relationship between high-frequency right ventricular pacing and paroxysmal atrial fibrillation burden. Europace. 2009 Nov;11(11):1456-61. doi: 10.1093/europace/eup218. Epub 2009 Aug 6.Toff WD, Camm AJ, Skehan JD; United Kingdom Pacing and Cardiovascular Events Trial Investigators.  Single-chamber versus dual-chamber pacing for high-grade atrioventricular block.  N Engl J Med. 2005 Jul 14;353(2):145-55.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H, Gasparini M, Linde C, Morgado FB, Oto A, Sutton R, Trusz-Gluza M; European Society of Cardiology; European Heart Rhythm Association.  Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology.  Developed in collaboration with the European Heart Rhythm Association. Eur Heart J. 2007 Sep;28(18):2256-95. Epub 2007 Aug 28.Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, Kellen JC, Greene HL, Michel MC, Dalquist JE, Corley SD; Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators.   A comparison of rate control and rhythm control in patients with atrial fibrillation.   N Engl J Med.  2002 Dec 5:347(23):1825-33.Zhan C, Baine WB, Sedrakyan A, Steiner C.  Cardiac device implantation in the United States from 1997 through 2004:  a population-based analysis.  J Gen Intern Med.  2008 Jan;23 Suppl 1:13-9.  doi:  10.1007/s11606-007-0392-0.
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
Related MaterialLiterature ReviewFDA MaterialOther Material 1Federal Coverage Denial Noticesame spacer from search pagecolrowPage Help forNCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision MemoCloseDecision MemoThedecision memorandumis the public document that lays out and describes the analytic framework for our decision on a topic under NCD review. Its purpose is to inform the reader of the decision, the reasons for the decision and process followed, and provide a summary of the evidence considered. The decision memorandum alerts the public of our intent to implement the decision at some point in the future. The effective date of the NCD will be the date the decision memo is issued.Submit Feedback/Ask a Questioncontainer-fluidGet email updatesSign up to get the latest information about your choice of CMS topics in your inbox. Also, you can decide how often you want to get updates.SIGN UPopens in new windowCMS & HHS WEBSITESMedicare.govopens in new windowMedicaid.govopens in new windowInsureKidsNow.govopens in new windowHealthCare.govopens in new windowHHS.govopens in new windowHELPFUL LINKSAcronymsArchiveContactsGlossaryPrivacy policyRSS FEEDSNewsroomBlogPodcastopens in new windowopens in new windowA federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services.7500 Security Boulevard, Baltimore, MD 21244opens in new windowopens in new windowopens in new windowTOOLSWeb policiesopens in new windowPlain languageopens in new windowNo Fear Actopens in new windowFreedom of Information Actopens in new windowInspector Generalopens in new windowFrequently Asked Questions (FAQs)Many questions can be answered on theHelp & Resources pagein the How To Library or by viewing the FAQs below. Please take a look and if you still have questions or would like to leave feedback,contact us!Are you a provider and have a question about billing or coding?Please contact your Medicare Administrative Contractor (MAC). MACs can be found in theMAC Contacts Report.Do you have questions related to the content of a specific Local Coverage Determination (LCD) or an Article?
NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
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NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
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NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
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NCA - Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemakers (CAG-00063R3) - Decision Memo
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Article - Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing (A54961)
CMS National Coverage PolicyN/AArticle TextAbstract:The National Coverage Determination (NCD) 20.8.3, Single Chamber and Dual Chamber Permanent Cardiac Pacemakers were revised with an effective date of August 13, 2013. The CMS A/B Medicare Administrative Contractors (MACs) have been instructed to implement the NCD at the local level. The following provides coding and billing instructions for the implementation of NCD 20.8.3. (CMS policy language is initalics.) The NCD Item/Service Description and Indications and Limitations are repeated here.Item/Service DescriptionA. GeneralPermanent cardiac pacemakers refer to a group of self-contained, battery operated, implanted devices that send electrical stimulation to the heart through one or more implanted leads. They are often classified by the number of chambers of the heart that the devices stimulate (pulse or depolarize). Single chamber pacemakers typically target either the right atrium or right ventricle. Dual chamber pacemakers stimulate both the right atrium and the right ventricle.The implantation procedure is typically performed under local anesthesia and requires only a brief hospitalization. A catheter is inserted into the chest and the pacemakers leads are threaded through the catheter to the appropriate chamber(s) of the heart. The surgeon then makes a small pocket in the pad of the flesh under the skin on the upper portion of the chest wall to hold the power source. The pocket is then closed with stitches.The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to conclude that implanted permanent cardiac pacemakers, single chamber or dual chamber, are reasonable and necessary for the treatment of non-reversible symptomatic bradycardia due to sinus node dysfunction and second and/or third degree atrioventricular block. Symptoms of bradycardia are symptoms that can be directly attributable to a heart rate less than 60 beats per minute (for example: syncope, seizures, congestive heart failure, dizziness, or confusion).Indications and Limitations of CoverageB. Nationally Covered IndicationsThe following indications are covered for implanted permanent single chamber or dual chamber cardiac pacemakers:
Article - Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing (A54961)
Indications and Limitations of CoverageB. Nationally Covered IndicationsThe following indications are covered for implanted permanent single chamber or dual chamber cardiac pacemakers:Documented non-reversible symptomatic bradycardia due to sinus node dysfunction, andDocumented non-reversible symptomatic bradycardia due to second degree and/or third degree atrioventricular block.C. Nationally Non-Covered IndicationsThe following indications are non-covered for implanted permanent single chamber or dual chamber cardiac pacemakers:Reversible causes of bradycardia such as electrolyte abnormalities, medications or drugs, and hypothermia,Asymptomatic first degree atrioventricular block,Asymptomatic sinus bradycardia,Asymptomatic sino-atrial block or asymptomatic sinus arrest,Ineffective atrial contractions (e.g., chronic atrial fibrillation or flutter, or giant left atrium) without symptomatic bradycardia,Asymptomatic second degree atrioventricular block of Mobitz Type I unless the QRS complexes are prolonged or electrophysiological studies have demonstrated that the block is at or beyond the level of the His Bundle (a component of the electrical conduction system of the heart),Syncope of undetermined cause,Bradycardia during sleep,Right bundle branch block with left axis deviation (and other forms of fascicular or bundle branch block) without syncope or other symptoms of intermittent atrioventricular block,Asymptomatic bradycardia in post-myocardial infarction patients about to initiate long-term beta-blocker drug therapy,Frequent or persistent supraventricular tachycardias, except where the pacemaker is specifically for the control of tachycardia, andA clinical condition in which pacing takes place only intermittently and briefly, and which is not associated with a reasonable likelihood that pacing needs will become prolonged.D. OtherMedicare Administrative Contractors will determine coverage under section 1862(a)(1)(A) of the Social Security Act for any other indications for the implantation and use of single chamber or dual chamber cardiac pacemakers that are not specifically addressed in this national coverage determination.(This NCD last reviewed August 2013.)
Article - Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing (A54961)
Please note:The Decision Memo for Cardiac Pacemakers: Single-Chamber and Dual-Chamber Permanent Cardiac Pacemaker (CAG-00063R3) states:CMS initiated this current national coverage analysis to reconsider coverage indications for single chamber and dual chamber cardiac pacemakers. The scope of this reconsideration and this decision memorandum does not address biventricular pacemakers, pacemakers that stimulate more than two heart chambers, those devices used to treat tachyarrhythmias and cardiac dyssynchrony, cardiac resynchronization therapy, cardiac pacemaker evaluation services, or self-contained pacemaker monitors.Medicare Administrative Contractors will determine coverage under section 1862(a)(1)(A) of the Social Security Act for any other indications for the implantation and use of single chamber or dual chamber cardiac pacemakers that are not specifically addressed in this national coverage determination.The coding and billing guidelines only apply to those CPT codes for the initial insertion of cardiac pacemakers:33206 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial33207 ventricular33208 atrial and ventricularThis NCD does not address replacement of pacemaker generators. CPT codes 33227, 33228, and 33229 or 33233 are therefore not addressed in this coding article.CMS NCD Covered Conditions and Diagnosis Codes  Group IClinical Conditions:Documented non-reversible symptomatic bradycardia due to sinus node dysfunctionDocumented non-reversible symptomatic bradycardia due to second degree and/or third degree atrioventricular blockDiagnosis Codes (ICD-9-CM /ICD-10-CM) (Attest with Modifier - KX):Atrioventricular (AV) block (426.0 / I44.2)Mobitz (type II) AV block (426.12 / I44.1)Other second degree AV block (426.13 / I44.1)Sinoatrial node dysfunction/Sick sinus syndrome (427.81 / I49.5)Congenital heart block (746.86 / Q24.6)
Article - Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing (A54961)
Contractor (Additional) Diagnosis Codes (ICD-9-CM /ICD-10-CM) Allowed by the NCD  Group II (Attest with Modifier - KX)