RESOURCES FOR DIAGNOSTICS AND DEVICE MONITORING CARDIAC RHYTHM AND HEART FAILURE

SUBCUTANEOUS CARDIAC RHYTHM MONITORS

pdf Reimbursement guide: LINQ™ family of subcutaneous cardiac rhythm monitors (.pdf)

Provides updated codes and Medicare payment rates in all sites of service for insertion/removal/monitoring for subcutaneous cardiac rhythm monitoring devices.

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A coding and payment overview for subcutaneous cardiac rhythm monitors.
pdf Reimbursement update for pediatric indication of LINQ II™ insertable cardiac monitor (.pdf)

The LINQ II™ ICM is the first subcutaneous rhythm monitor available for use in patients as young as two years old.

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Reimbursement update for LINQ II pediatric indication
pdf Reimbursement update for subcutaneous cardiac rhythm monitory procedures (.pdf)

Effective January 1, 2023 there are changes to the Medicare Physician Fee Schedule (MPFS) and Outpatient Prospective Payment System (OPPS) impacting payment for subcutaneous cardiac rhythm monitor procedures.

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Document is a detailed description of the CY2023 Medicare reimbursement update associated with SCRM procedures.

Prior authorization tools and resources

Process examples, submission guidance, sample letters, and a bibliography to support prior authorization

pdf Prior authorization guide (.pdf)

Comprehensive instruction guide offering considerations for submitting prior authorizations to patient's insurance, including initial prior authorization, prior authorization appeals, and peer-to-peer review.

This prior authorization guide offers generic prior authorization process considerations.
pdf Prior authorization resources for subcutaneous cardiac rhythm monitors (.pdf)

Provides example letter of medical necessity to submit with prior authorization requests and an example prior authorization appeal letter in the instance of a prior authorization denial. It also includes a bibliography of evidence to support prior authorization.

This prior authorization resource offers example letters and a bibliography for subcutaneous cardiac rhythm monitors.

Cost Effectiveness Analysis

Access videos to learn about cost effectiveness analysis and how decision makers use these analyses.

Video: Cost effectiveness analysis — an introduction

Watch a video to learn about cost effectiveness analysis, a methodology designed to evaluate which interventions provide the highest value for the cost associated.

Video: Cost effectiveness analysis — Medtronic ICMs in cryptogenic stroke patients

Watch a video to learn how healthcare decision makers use cost effectiveness analysis using Medtronic ICMs in cryptogenic stroke patients as an example. 

CARDIAC DEVICE MONITORING

pdf Procedure codes: device monitoring services (.pdf)

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Commonly billed procedure codes for cardiac device monitoring services.
pdf Reimbursement guide: cardiac implantable electronic device (CIED) management services (.pdf)

Provides coverage, coding, and Medicare payment information for cardiac implantable electronic device (CIED) patient management services.

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This document provides coding, coverage, and payment information for cardiac implantable electronic device (CIED) management services.
pdf Reimbursement overview: CareLink Express™ Mobile (.pdf)

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Reimbursement Overview: CareLink Express Mobile
pdf Reimbursement overview: CareLink SmartSync™ MRI access application  (.pdf)

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CareLink SmartSync MRI Access Application Reimbursement Overview

Looking for relative value unit (RVU) information? Our RVU guide can be found with additional coding resources on the coding reference page.