WATCHMAN Reimbursement Guide
WATCHMANREIMBURSEMENTGUIDEThis comprehensive guide provides an overview of the coding,coverage and payment landscape for the WATCHMAN system.For questions regarding WATCHMAN reimbursement,please contact:Email: WATCHMAN.Reimbursement@bsci.comPlease go to www.watchmandownloadcenter.comfor additional resources.The FDA Approved the WATCHMANTM on March 13, 2015 and on July21, 2020 they approved WATCHMAN FLXTMTo access the percutaneous LAAC (WATCHMANTM and WATCHMANFLXTM) approval document, visit the FDA websiteIC-528304-AFREIMBURSEMENT GUIDE
CAUTION: Federal law (USA) restricts this device to sale by or on the order of a physician. Rx only. Prior to use, please see the complete“Directions for Use” for more information on Indications, Contraindications, Warnings, Precautions, Adverse Events, and Operator’sInstructions.INDICATIONS FOR USEWATCHMAN Device is indicated to reduce the risk of thromboembolism from the left atrial appendage in patients with non-valvular atrialfibrillation who: Are at increased risk for stroke and systemic embolism based on CHADS2 or CHA2DS2-VASc scores and are recommended foranticoagulation therapy; Are deemed by their physicians to be suitable for warfarin; and Have an appropriate rationale to seek a non-pharmacologic alternative to warfarin, taking into account the safety and effectiveness of thedevice compared to warfarin.CONTRAINDICATIONSDo not use the WATCHMAN Device if: Intracardiac thrombus is present. An atrial septal defect repair or closure device or a patent foramen ovale repair or closure device is present. The LAA anatomy will not accommodate a device. See Table 47 (in the DFU). Any of the customary contraindications for other percutaneous catheterization procedures (e.g., patient size too small to accommodate TEEprobe or required catheters) or conditions (e.g., active infection, bleeding disorder) are present. There are contraindications to the use of warfarin, aspirin, or clopidogrel. The patient has a known hypersensitivity to any portion of the device material or the individual components (see Device Description section)such that the use of the WATCHMAN device is contraindicated.WARNINGS Device selection should be based on accurate LAA measurements obtained using echocardiographic imaging guidance (TEE recommended)in multiple angles (e.g., 0º, 45º, 90º, 135º). Do not release the WATCHMAN Device from the core wire if the device does not meet all release criteria. If thrombus is observed on the device, warfarin therapy is recommended until resolution of thrombus is demonstrated by TEE. The potential for device embolization exists with cardioversion 30 days following device implantation. Verify device position postcardioversion during this period. Administer appropriate endocarditis prophylaxis for 6 months following device implantation. The decision to continue endocarditisprophylaxis beyond 6 months is at physician discretion. For single use only. Do not reuse, reprocess or resterilize.PRECAUTIONS The safety and effectiveness (and benefit-risk profile) of the WATCHMAN Device has not been established in patients for whom long-termanticoagulation is determined to be contraindicated. The LAA is a thin-walled structure. Use caution when accessing the LAA and deploying the device. Use caution when introducing the WATCHMAN Access System to prevent damage to cardiac structures. Use caution when introducing the Delivery System to prevent damage to cardiac structures. To prevent damage to the Delivery Catheter or device, do not allow the WATCHMAN Device to protrude beyond the distal tip of the DeliveryCatheter when inserting the Delivery System into the Access Sheath. If using a power injector, the maximum pressure should not exceed 100 psi. In view of the concerns that were raised by the RE-ALIGN study of dabigatran in the presence of prosthetic mechanical heart valves, cautionshould be used when prescribing oral anticoagulants other than warfarin in patients treated with the WATCHMAN Device. The WATCHMANDevice has only been evaluated with the use of warfarin post-device implantation.ADVERSE EVENTSPotential adverse events (in alphabetical order) which may be associated with the use of the WATCHMAN Implant or implantation procedureinclude but are not limited to: air embolism, airway trauma, allergic reaction to contrast media, anesthetic, WATCHMAN Implant material, ormedications, altered mental status, anemia requiring transfusion, anesthesia risk, angina, anoxic encephalopathy, arrhythmias, atrial septaldefect, bruising, hematoma or seroma near the catheter insertion site, cardiac perforation, chest pain/discomfort, confusion post procedure,congestive heart failure, contrast related nephropathy, cranial bleed, death, decreased hemoglobin, deep vein thrombosis, device embolism,device fracture, device thrombosis, edema, embolism, excessive bleeding, fever, fistula, groin pain, groin puncture bleed, hematuria,hemoptysis, hypotension, hypoxia, improper wound healing, inability to reposition, recapture, or retrieve the device, infection/pneumonia,interatrial septum thrombus, intratracheal bleeding, major bleeding requiring transfusion, misplacement of the device/improper seal of theappendage/movement of device from appendage wall, myocardial erosion, nausea, oral bleeding, pericardial effusion/tamponade, pleuraleffusion, prolonged bleeding from a laceration, pseudoaneurysm, pulmonary edema, renal failure, respiratory insufficiency/failure, surgicalremoval of the device, stroke – hemorrhagic, stroke – ischemic, systemic embolism, TEE complications (throat pain, bleeding, esophagealtrauma), thrombocytopenia, thrombosis, transient ischemic attack (TIA), valvular or vascular damage, vasovagal reactions.There may be other potential adverse events that are unforeseen at this time.1 Eikelboom JW, Connolly SJ, Brueckmann M, et al. N Engl J Med 2013;369:1206-14.
TABLE OF CONTENTSWATCHMAN Left Atrial Appendage Closure Device2021 Reimbursement GuideCoding Summary.3ICD-10-CM Diagnosis Codes.4Hospital Reimbursement . 5-7Physician Reimbursement .8-11Professional Claim Billing Instructions.12-13Institutional Hospital Claims Billing Instructions.14-16Discontinued or Aborted Procedure for Inpatient Services.17-18Concomitant Procedure Billing. 19-20National Coverage Determination (NCD). 21-23Medicare Advantage, Medicaid and Commercial Insurance. 24-27Additional Resources – Health Economics and Market Access Webinars.28REIMBURSEMENT GUIDE
IMPORTANT INFORMATIONHealth economic and reimbursement information provided by BostonScientific Corporation is gathered from third-party sources and issubject to change without notice as a result of complex and frequentlychanging laws, regulations, rules and policies. This information ispresented for illustrative purposes only and does not constitutereimbursement or legal advice. Boston Scientific encouragesproviders to submit accurate and appropriate claims for services.It is always the provider’s responsibility to determine medical necessity, the proper sitefor delivery of any services and to submit appropriate codes, charges, and modifiersfor services that are rendered.Boston Scientific recommends that you consult with your payers,reimbursement specialists and/or legal counsel regarding coding,coverage and reimbursement matters. Boston Scientific does notpromote the use of its products outside their FDA-approved label.CPT Copyright 2019 American Medical Association. All rights reserved.CPT is a registered trademark of the American Medical Association.Applicable FARS/DFARS Restrictions Apply to Government Use. Feeschedules, relative value units, conversion factors and/or relatedcomponents are not assigned by the AMA, are not part of CPT, andthe AMA is not recommending their use. The AMA does not directlyor indirectly practice medicine or dispense medical services. The AMAassumes no liability for data contained or not contained herein.Payer policies will vary and should be verified prior to treatment forlimitations on diagnosis, coding or site of service requirements. Thecoding options listed within this guide are commonly used codes andare not intended to be an all-inclusive list. We recommend consultingyour relevant manuals for appropriate coding options.2 REIMBURSEMENT GUIDE
CODING SUMMARYHospital InpatientCodingPaymentICD-10-PCS Procedure Code 02L73DKMS-DRG 273 or MS-DRG 274PhysicianCPT Code 3334014 Work RVUs23.06 Total RVUsICD-10-CM Diagnosis CodesI48.91 Unspecified Atrial FibrillationI48.20 Chronic Atrial Fibrillation, Unspecified*DiagnosisCodesI48.21 Permanent Atrial FibrillationI48.0 Paroxysmal Atrial FibrillationI48.11 Longstanding Persistent Atrial FibrillationI48.19 Other Persistent Atrial FibrillationOriginal Medicare – CMS National Coverage Determination(NCD CED 20.34) establishes uniform coverage criteria1CoverageMedicare Advantage – Medicare Advantage plans must coverall the services that Original Medicare covers. The NCD CED20.34 coverage criteria for Original Medicare also providescoverage to Medicare Advantage Patients2Private Payers – Coverage dependent on individual payer policy* The unspecified code is NOT COVERED under the NCD for LAAC. LAAC claims reported with thisdiagnosis code will be denied. Some private payers have included this ICD-10-CM code in theircoverage policy1 ails/nca-decision-memo.aspx?NCAId 2812 ns-cover-all-medicare-servicesREIMBURSEMENT GUIDE 3
ICD-10-CM DIAGNOSIS CODESICD-10-CM Atrial Fibrillation Diagnosis Coding UpdateUpdates to ICD-10-CM diagnosis codes related to Atrial Fibrillationwere announced in the FY 2020 IPPS Final Rule and were effectiveas of October 1, 2019. Updates are described in CMS 2382, changerequest #11491.Use of the new codes is required to facilitate claims processingfor services associated with an AF diagnosis, including Left AtrialAppendage Closure (LAAC).Previous Code(s) AssignmentEnd Date September 30, 2019Current Code AssignmentFY 2020 – Effective October 1, 2019I48.91 Unspecified Atrial FibrillationI48.91 Unspecified Atrial FibrillationI48.2 Chronic Atrial FibrillationI48.20 Chronic Atrial Fibrillation,Unspecified*I48.0 Paroxysmal Atrial FibrillationI48.1 Persistent Atrial FibrillationI48.21 Permanent Atrial FibrillationI48.0 Paroxysmal Atrial FibrillationI48.11 Longstanding PersistentAtrial FibrillationI48.19 Other Persistent AtrialFibrillation* The unspecified code is NOT COVERED under the NCD for LAAC. LAAC claims reported with thisdiagnosis code will be denied.4 REIMBURSEMENT GUIDE
HOSPITAL REIMBURSEMENTMedicare classifies WATCHMAN LAAC procedures as Inpatient-only.The “Two-Midnight Rule” is not applicable for procedures restricted tothe Inpatient Only (IPO) list.ICD-10-PCS02L73DKMS-DRGMS-DRG DescriptionOcclusion of left atrial appendage with intraluminal device,percutaneous approach.MS-DRG DescriptionFY 2022NationalAveragePayment*MS-DRG 273Percutaneous Intracardiac Procedureswith MCC 25,234MS-DRG 274Percutaneous Intracardiac Procedureswithout MCC 21,673*Centers for Medicare and Medicaid Services. Medicare Program: FY 2022 Hospital Inpatient ProspectivePayment System, Final Rule; September, MS018912.htmlREIMBURSEMENT GUIDE 5
HOSPITAL REIMBURSEMENTContinuedTransesophageal Echocardiogram (TEE) — Baseline and Follow-UpCodeDescriptionAPCCY 2021NationalAveragePayment*93312Echocardiography, transesophageal,real-time with image documentation(2D) (with or without M-moderecording); including probe placement,image acquisition, interpretationand report.5524 483*Commercial payment will vary and will be at discretion of the payer.Computed Tomography (CT) — Baseline and Follow-UpCodeDescription75572Computed tomography, heart, withcontrast structure and morphology(including 3D image postprocessing,assessment of cardiac function, andevaluation of venous structures, ifperformed).75574Computed tomography, heart,coronary arteries and bypass grafts(when present), with contrast material,including 3D image postprocessing(including evaluation of cardiacstructure and morphology, assessmentof cardiac function, and evaluation ofvenous structures, if performed).*Commercial payment will vary and will be at discretion of the payer.6 REIMBURSEMENT GUIDEAPCCY 2021NationalAveragePayment*5571 179
HOSPITAL REIMBURSEMENTContinuedTransesophageal Echocardiogram (TEE) — IntraoperativeCodeDescriptionAPCCY 2021NationalAveragePayment*93355Echocardiography, transesophageal(TEE) for guidance of a transcatheterintracardiac or great vessel(s) structuralintervention(s) (e.g.,TAVR, transcatheterpulmonary valve replacement, mitralvalve repair, paravalvular regurgitationrepair, left atrial appendage occlusion/closure, ventricular septal defectclosure) (peri-and intra-procedural),real-time image acquisition anddocumentation, guidance withquantitative measurements, probemanipulation, interpretation, and report,including diagnostic transesophagealechocardiography and, whenperformed, administration ofultrasound contrast, Doppler, colorflow, and 3D.NotApplicable– N StatusIndicatorBundledService*Commercial payment will vary and will be at discretion of the payer.REIMBURSEMENT GUIDE 7
PHYSICIAN REIMBURSEMENTWATCHMAN LAAC ProcedureCodeDescription33340Percutaneous transcatheter closureof the left atrial appendage withimplant, including fluoroscopy,transseptal puncture, catheterplacement(s), left atrial angiography,left atrial appendage angiography,radiological supervision andinterpretation.RVU14.00 workRVUs23.06 TotalRVUsCY 2021NationalAveragePayment* 805*Commercial payment will vary and will be at discretion of the payer.Same Physician Performing Implant and Intraoperative TEE PT 33340 (WATCHMAN) and 93355 (Intraoperative TEE) can not be billed by theCphysician billing 33340.1 Medicare – National Correct Coding Policy Manual, Physician Version 23.0/Policy Narratives(1/1/2017): Chapter I General Correct Coding Policies, Excerpt – Section E.8 REIMBURSEMENT GUIDE
PHYSICIAN REIMBURSEMENTContinuedCo-Surgeon BillingCPT Code Modifier33340-62DescriptionLeft atrial appendage closure can be billed by two surgeonsby appending the -62 modifier to 33340 (eg. 33340-62). If two surgeons (each of a different specialty) are required toperform a specific procedure, each surgeon bills for theprocedure with a modifier of “-62” Each operator is required to submit their own post-operativenote and must report 33340-62 The fee schedule amount applicable to the paymentfor each co-surgeon is 62.5 percent of the globalsurgery fee amountTransesophageal Echocardiogram (TEE) — Baseline and sesophageal, real-time withimage documentation (2D) (withor without M-mode recording);including probe placement,image acquisition, interpretationand report.RVUCY 2021NationalAveragePayment**2.30 workRVUs7.23 TotalNonFacilityRVUs3.13 TotalFacilityRVUs (-26)Global 252Professional 109*Commercial payment will vary and will be at discretion of the payer.** Global includes professional and technical services. Professional only includes services reported with-26 modifier.REIMBURSEMENT GUIDE 9
PHYSICIAN REIMBURSEMENTContinuedComputed Tomography (CT) — Baseline and Follow-UpCode7557275574DescriptionComputed tomography, heart,with contrast material, forevaluation of cardiac structureand morphology (including3D image postprocessing,assessment of cardiac function,and evaluation of venuousstructures, if performed).Computed tomographicangiography, heart, coronaryarteries and bypass grafts(when present), with contrastmaterial, including 3D imagepostprocessing (includingevaluation of cardiac structureand morphology, assessment ofcardiac function, and evaluationof venous structures, ifperformed)RVUCY 2021NationalAveragePayment*1.75 workRVUs7.96NonFacilityTotal RVUs2.43FacilityTotal RVUs(-26)Global 278Professional 852.40 workRVUs11.64NonFacilityTotal RVUs3.35FacilityTotal RVUs(-26)Global 406Professional 117**Commercial payment will vary and will be at discretion of the payer.** Global includes professional and technical services. Professional only includes services reported with-26 modifier.10 REIMBURSEMENT GUIDE
PHYSICIAN REIMBURSEMENTContinuedTransesophageal Echocardiogram (TEE) — ,transesophageal (TEE) forguidance of a transcatheterintracardiac or great vessel(s)structural intervention(s)(e.g.,TAVR, transcatheterpulmonary valve replacement,mitral valve repair, paravalvularregurgitation repair, leftatrial appendage occlusion/closure, ventricular septaldefect closure) (peri-and intraprocedural), real-time imageacquisition and documentation,guidance with quantitativemeasurements, probemanipulation, interpretation,and report, includingdiagnostic transesophagealechocardiography and, whenperformed, administration ofultrasound contrast, Doppler,color flow, and 3D.CY 2021NationalAveragePayment**RVU4.66 workRVUs6.61 TotalRVUs 231*Commercial payment will vary and will be at discretion of the payer.**Code 93355 RVU for global payment only, no separate professional component applies.Same Physician Performing Anesthesia and Intraoperative TEECPT 01926 (Anesthesia) and 93355 (Intraoperative TEE) can not be billed by thephysician billing 01926.1 Medicare – National Correct Coding Policy Manual, Physician Version 23.0/Policy Narratives(1/1/2017): Chapter I General Correct Coding Policies, Excerpt – Section E.REIMBURSEMENT GUIDE 11
PROFESSIONAL CLAIM BILLINGINSTRUCTIONS1 C PT Code 33340 Percutaneous transcatheter closure of the leftatrial appendage with implant, including fluoroscopy transseptalpuncture, catheter placement(s), left atrial angiography, left atrialappendage angiography, radiological supervision and interpretation2 Principal ICD-10-CM Diagnosis Code (one of the following): I48.0 – Paroxysmal atrial fibrillation I48.11 – Longstanding persistent atrial fibrillation I48.19 – Other persistent atrial fibrillation I48.20 – Chronic atrial fibrillation, unspecified* I48.21– Permanent atrial fibrillation I48.91 – Unspecified atrial fibrillation3 Place of Service Code of 21 – Inpatient hospital4. Secondary Diagnosis Code Z00.6 – Encounter for exam ofparticipant in clinical research program to indicate a patient isparticipating in LAAO Registry5. Modifier Q0 – Indicating the procedure is an investigational clinicalservice provided in an approved clinical research study6. Clinical Trial Number – CT 02699957The 8-digit clinical trial registry number preceded by the alpha characteristic “CT”, is placed infield/item 19 of the CMS 1500 claim form or in the electronic claim equivalent 837p in Loop 2300REF02(REF01 P4)(this is actually field/item 23).* The unspecified code is NOT COVERED under the CMS NCD for LAAC. Some private payers haveincluded this ICD-10 code in their coverage policy12 REIMBURSEMENT GUIDE
CMS 1500 Claim Example for WATCHMAN LAAO DeviceItem 21A designates the primary diagnosiscodes as required by Medicare. One of thefollowing diagnosis codes are allowed:I48.0-Paroxysmal atrial fibrillationI48.11-Longstanding persistent atrial fibrillationI48.19-Other persistent atrial fibrillationI48.20-Chronic atrial fibrillation, unspecified*I48.21-Permanent atrial fibrillationI48.91-Unspecified atrial fibrillation*The unspecified code is NOT COVEREDunder the CMS NCD for LAAC. Some privatepayers have included this ICD-10 code in theircoverage policyI480Item 21B designates thesecondary ICD-10-CMdiagnosis code Z00.6(Encounter for examination ofparticipant in clinical researchprogram) to indicate thepatient is participating in theLAAO registry.Item 23 designates theNational Clinical Trial(NCT) number for the LeftAtrial Appendage Occlusion(LAAO) registry.0Z006CT0269995701 01170102Item 24B designatesplace of service (POS)21 for inpatient hospitalas required byMedicare.172133340Q0Item 24D designates theCPT Code 33340 for theWATCHMANTM device.A,B1Item 24D designates the HCPCSmodifier Q0 (Investigational serviceprovided in a clinical research study)to indicate the patient is participatingin the LAAO registry.Sources:Items 21A-21B & 24B-24D) CMSMedicare Claims Processing Transmittal 3515; Medlearn Matters Number MM9638 Item 23-1) CMS Medicare MedlearnMatters Number MM9638; Claims Processing Transmittal 2955Item 23-2) Left Atrial Appendage Occlusion Registry, clinicaltrials.gov; -Evidence-Development/LAAC.htmlItem 24D) Official AMA CPT code description 33340 Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, includingfluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiologicalsupervision and interpretation.IC-420005-AC
INSTITUTIONAL HOSPITAL CLAIMSBILLING INSTRUCTIONS1 I CD-10-PCS Procedure Code 02L73DK Occlusion of Left AtrialAppendage with Intraluminal Device, Percutaneous Approach2 Principal ICD-10-CM Diagnosis Code of one of the following: I48.0 – Paroxysmal atrial fibrillation I48.11 – L ongstanding persistent atrial fibrillation I48.19 – Other persistent atrial fibrillation I48.20 – Chronic atrial fibrillation, unspecified* I48.21 – Permanent atrial fibrillation I48.91 – Unspecified atrial fibrillation3 S econdary Diagnosis Code Z00.6 – Encounter for exam ofparticipant in clinical research program to indicate a patient isparticipating in LAAO Registry4. Condition Code 30 – Qualifying Clinical Trial5. Value Code D4 – Clinical Trial Number (NCT 02699957) is listedon the CMS website: clinicaltrials.gov* The unspecified code is NOT COVERED under the CMS NCD for LAAC. Some private payers haveincluded this ICD-10-CM code in their coverage Coding/ICD10/2020-ICD-10-CM.html14 REIMBURSEMENT GUIDE
REC. #CMS Inpatient UB-04 Claim Example for WATCHMANTM LAAO Device cbb10 BIRTHDATE11 SEX04/28/201712DATEADMISSION13 HR 14 TYPE 15 SRC 16 DHR 17 TECONDITION CODES2422232135CODE25262736CODEOCCURRENCE SPANFROMTHROUGHd28e29 ACDT 30STATE37OCCURRENCE SPANFROMTHROUGHaabb3839CODEaItem 18 designates thecondition code whichindicates a qualifyingclinical trial.42 REV. CD.D440CODEVALUE CODESAMOUNT0269995741CODEVALUE CODESAMOUNTVALUE CODESAMOUNTbcd44 HCPCS / RATE / HIPPS CODE43 DESCRIPTION45 SERV. DATE46 SERV. UNITS47 TOTAL CHARGES48 NON-COVERED CHARGES491122Item 39 designates the value codeand National Clinical Trial (NCT)number for the Left AtrialAppendage Occlusion (LAAO)registry.3456345677889910101111Item 66/67 designates the primarydiagnosis codes as required byMedicare. One of the followingdiagnosis codes is allowed:I48.0-Paroxysmal atrial fibrillationI48.11-Longstanding persistent atrialfibrillationI48.19-Other persistent atrialfibrillationI48.20-Chronic atrial fibrillation,unspecified*I48.21-Permanent atrial fibrillationI48.91-Unspecified atrial fibrillation121314151617181920212223*The unspecified code is NOTCOVERED under the CMS NCD forLAAC. Some private payers haveincluded this ICD-10 code in theircoverage policyABC12131415Item 67A designates thesecondary ICD-10-CM diagnosiscode Z00.6 (Encounter forexamination of participant in clinicalresearch program) to indicate thepatient is participating in the LAAOregistry.16171819202122TOTALSCREATION DATE52 REL.INFO51 HEALTH PLAN ID53 ASG.BEN.2355 EST. AMOUNT DUE54 PRIOR PAYMENTS57AOTHERBPRV IDC62 INSURANCE GROUP NO.61 GROUP NAME59 P. REL 60 INSURED’S UNIQUE ID56 NPIAABC64 DOCUMENT CONTROL63 TREATMENT AUTHORIZATION CODESABC66DXI48067IZ006AJ69 ADMIT70 PATIENTDXREASON DXPRINCIPAL PROCEDUREa.74CODEDATE02L73DKc.BKabCLOTHER PROCEDURECODEDATEb.OTHER PROCEDUREDATECODEe.cItem 74 designates the principal ICD-10PCS code. Code 02L73DK (Occlusion ofLeft Atrial Appendage with IntraluminalDevice, Percutaneous Approach)represents the designated code for theWATCHMAN device.DM71 PPSCODEOTHER PROCEDURECODEDATE03/20/2017OTHER PROCEDURECODEDATEEN7572ECIFOa76 ATTENDINGGPbNPILASTd.OTHER PROCEDURECODEDATE77 ces: Left Atrial Appendage Occlusion Registry, clinicaltrials.gov, age-with-Evidence-Development/LAAC.html CMS Manual System, Pub 100-04 Claim Processing, Transmittal 3515; ce/Transmittals/Downloads/R3515CP.pdfIC-471408-AA MAY2017
INSTITUTIONAL HOSPITAL CLAIMS BILLING INSTRUCTIONSContinuedDevice C-CodeThe WATCHMAN device is classified by Medicare as an “InpatientOnly” procedure therefore no HCPCS device category C-code existsfor WATCHMAN A hospital may assign its own internal charge code, associatedwith an appropriate revenue code, to record the cost of thedevice. If a device category C-code is required by the hospital chargingsystem, please review the web link below for the CMS approvedlist as of July 1, 2020.Using the camera on your phone, scan the QR code and visit the Complet-list-DeviceCats-OPPS.pdf16 REIMBURSEMENT GUIDE
DISCONTINUED OR ABORTED PROCEDUREFOR IN-PATIENT SERVICESDiscontinued or Aborted Procedures vary based on patient case detailsand physician documentation. The following scenario representsonly one type of case. Consult AHA Coding Clinic and Official CodingGuidelines in the event of other clinical scenarios.Scenario: During same operative episode the WATCHMAN device wasinserted, determined by the physician to be inadequate and the devicewas removed.ICD-10 PCS 02H73DZ Insertion of Intraluminal Device into Left Atrium, PercutaneousApproach Root Operation Definition: Putting in a nonbiological appliance that monitors,assists, performs, or prevents a physiological function but does not physicallytake the place of a body part.ANDICD-10 PCS 02PA3DZ Removal of Intraluminal Device from Heart, PercutaneousApproach Root Operation Definition: Taking out or off a device from a body part.2020 ICD-10 PCS Official Guidelines for Coding and Reporting (page 76), Guideline B6.1a.American Hospital Association (AHA) Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017: Page 104;Fourth Quarter ICD-10 2018 Page: 94REIMBURSEMENT GUIDE 17
DISCONTINUED OR ABORTEDPHYSICIAN SERVICES CPT Code 33340 May use modifier 53 for a Discontinued Procedure The modifier is used to report services or procedures whenthe service/procedure is discontinued after anesthesia isadministered to the patient. Submit the length/amount ofprocedure completed and reason for discontinued services. The physician can only code for what was accomplished inthe procedure (e.g., groin access; or, transseptal puncture andimaging; or, inspection, insertion and removal)2019 ICD-10 PCS Official Guidelines for Coding and Reporting (page 76), Guideline B6.1a.American Hospital Association (AHA) Coding Clinic for ICD-10-CM/PCS, Fourth Quarter 2017: Page 104;Fourth Quarter ICD-10 2018 Page: 9418 REIMBURSEMENT GUIDE
CONCOMITANT PROCEDURE BILLING FORHOSPITAL INPATIENT SERVICESMS-DRG HierarchyWhen a WATCHMAN device is performed during the same hospitaladmission as another procedure, only one MS-DRG is assigned forpayment. Since a patient can have multiple procedures related to theirprincipal diagnosis, and a patient can be assigned to only MSDRG, patients with multiple procedures are assigned to thesurgical class highest in the CMS defined hierarchy. Each case is specific to clinical circumstances of the admission. The assignment of the principal diagnosis and procedure arecritical for accurate MS-DRG assignment. Sequence procedure performed for definitive treatment mostrelated to principal diagnosis as principal procedure.Inpatient ReadmissionsWhen an inpatient hospital WATCHMAN device admission follows a previous inpatientadmission for a related or unrelated procedure, readmission policies may apply. Aquality review may be triggered and warrant a case review to evaluate combining theinpatient admissions. Each case is specific to clinical circumstances for each lcode cms/fullcode cms/Design and development of theDiagnosis Related Group EMENT GUIDE 19
CONCOMITANT PROCEDURE BILLING FORPHYSICIAN SERVICESWhen a WATCHMAN device is performed during the same operativeepisode as another procedure, the Medicare Multiple Discountingpolicy applies. Multiple Procedure Discount – payment adjustment rule formultiple procedures applies to the service. The WATCHMANprocedure is assigned a ‘2’ which indicates that standardpayment adj
Coding ICD-10-PCS Procedure Code 02L73DK CPT Code 33340 Payment MS-DRG 273 or MS-DRG 274 14 Work RVUs 23.06 Total RVUs Diagnosis Codes ICD-10-CM Diagnosis Codes I48.91 Unspecified Atrial Fibrillation I48.20 Chronic Atrial Fibrillation, Unspecified* I48.21 Permanent
medications, altered mental status, anemia requiring transfusion, anesthesia risk, angina, anoxic encephalopathy, arrhythmias, atrial septal . Brueckmann M, et al. N Engl J Med 2013;369:1206-14. REIMBURSEMENT GUIDE WATCHMAN Left Atrial Appendage Closure Device 2020 Reimbursement Guide
Aviation Real Estate Tax Reimbursement - Reimbursement Request. for public airports which are aviation-related areas between December 1, 2020 and February 1, 2021. To receive reimbursement of taxes paid, the airport owner will confirm their existing agreement with the Department and provide all necessary supporting tax documentation .
1 VII. Watchman Nee Watchman Nee1 was born on November 4, 1903, and died on c. June 1, 1972 in a Chinese communist prison camp. He founded the Little Flock, Local Church, or Church of the Recovery denomination2 and was an influential proponent of Keswick theology in China.3 His “name has beco
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