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Implantable Automatic Defibrillators (NCD 20.4)

Implantable Automatic Defibrillators (NCD ) Page 1 of 8 UnitedHealthcare Medicare Advantage Policy Guideline Approved 11/10/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services, Inc. UnitedHealthcare Medicare Advantage Policy Guideline Implantable Automatic Defibrillators (NCD ) Guideline Number: Approval Date: November 10, 2021 Terms and Conditions Table of Contents Page Policy Summary .. 1 Applicable Codes .. 3 References .. 5 Guideline History/Revision Information .. 7 Purpose .. 7 Terms and Conditions .. 7 Policy Summary See Purpose Overview An Implantable cardioverter- defibrillator (ICD) (also referred to as Defibrillators ) is an electronic device designed to diagnose and treat life-threatening ventricular tachyarrhythmias.

• Cardiac Pacemakers: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers (NCD 20.8.3) Related Medicare Advantage Reimbursement Policy Multiple Procedure Payment Reduction (MPPR) for Medical and Surgical Services Policy, Professional Related Medicare Advantage Coverage Summary • Cardiac Procedures: Pacemakers, Defibrillators and

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