1)
An insertable loop recorder will be covered:
a)
Only if a definitive diagnosis for syncope (R55) has not been made
after ALL of the following conditions
have been met:
i.
Complete history and physical examination;
ii.
Electrocardiogram (ECG);
iii.
Two (2) negative or non-diagnostic 30-day pre-symptom memory loop
patient demand recordings (may be either single or multiple event recordings);
iv.
Negative or non-diagnostic tilt table testing.
2)
Any other use of this device is considered not medically necessary
and will not be covered.
3)
The ILR device insertion procedure is considered to be a physician
service. It carries a 90 day global and does not require an assistant surgeon.
Removal of an ILR device on the same day as the insertion of a cardiac pacemaker
in any given patient is considered to be a part of the pacemaker insertion
procedure and will not be covered separately.
4)
Transcatheter insertion or replacement of permanent leadless
pacemaker (33274) is considered experimental and investigational for arrhythmias
and all other indications because of insufficient evidence of its safety and
effectiveness.
Codes
Used In This BI:
33274
Transcatheter insertion or replacement of permanent leadless pacemaker,
right ventricular, including imaging guidance (e.g., fluoroscopy, venous
ultrasound, ventriculography, femoral venography) and device evaluation (eg,
interrogation or programming), when performed
33282
Implantation of
patient-activated cardiac event recorder
(code deleted 1/1/19)
33285
Insertion, subcut cardiac rhythm monitor, incl programming
(new code 1/1/19)
93356
Myocardial strain imaging using speckle tracking-derived assessment of
myocardial mechanics (List separately in addition to codes for echocardiography
imaging)
E0616
Implantable cardiac event recorder w/memory, activator, and programmer