St. Jude Medical for Medical Professionals

Patient Education Materials

Reimbursement Support

Presentation Materials

Doctor Finder

This section of the Web site serves as a resource for physicians and other healthcare professionals, providing information regarding coding, coverage and payment for procedures associated with the use of St. Jude Medical products.

 

Reimbursement Updates

• 4/28/2008 - CMS Releases FY 2009 IPPS Proposed Rule
• 12/18/2007 – CPT 2008 Coding Changes: Modifier 51 Exemption
• 11/13/2007 – CMS Implements Steps to Promote Efficiencies Within the OPPS: Composite Payments Introduced for CY 2008
• 09/25/2007 – CMS Adopts Severity Adjusted DRGs for FY 2008: Payment Driven by Patient’s Secondary Diagnosis
• 05/26/2007 – Reporting Interrogation of Pacemakers and ICDs

 Coding References

• Product Crosswalk to Category "C" Codes
• Intracardiac Ablation and Related Procedures
• Implantable Cardioverter Defibrillator Procedures (including CRT-D)
• Cardiac Pacemaker Procedures (including CRT-P)
• Pacemaker/CRT-P and ICD/CRT-D Procedure Checklists
• Coding Update - Q0 Modifier

 Medicare National Coverage Determinations

• Medicare National Coverage Determinations (NCDs)
• Cardiac Catheterization Performed in Other than a Hospital Setting
• Cardiac Output Monitoring by Thoracic Electrical Bioimpedance
• Cardiac Pacemakers
• Home Prothrombin Time INR Monitoring for Anticoagulation Management
• Implantable Automatic Defibrillators
• Routine Costs in Clinical Trials
• Microvolt T-WAVE Alternans (MTWA)

 

Links To Additional Resources

• Medicare Local Coverage Determinations (LCDs) 
• Medicare Physician Fee Schedule Look-up
• MLN Matters Articles
• MM5680 August 29, 2007 – Testing and Implementation of 2008 Ambulatory Surgical Center (ASC) Payment System Changes
• MedPac Publications: Payment Basics
• The NCDR ICD Registry TM for Implantable Cardioverter Defibrillators
• National Correct Coding Initiatives Edits 

 

DISCLAIMER

This information is provided to assist users in understanding coding, coverage and payment for procedures associated St. Jude Medical products. Note that coding, coverage and payment can vary from setting to setting and from insurer to insurer. This information does not guarantee that use of any particular codes will result in coverage or payment at any specific level. Insurers make reimbursement decisions according to the insurer’s evaluation of the patient’s medical needs. The hospital and physician should select the code or codes that most accurately describe the patient’s conditions and the procedures performed and products used, and fully comply with the insurer requirements in submitting claims.

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