Does 33940 require prior authorization?

No, 33940 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 33940?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Adult Clinical Indications*- Adults with end-stage, irreversible, refractory, symptomatic HF requiringmaximalcontinuous medical or mechanical support must have:
A low functional status;and
Heart transplantation is consideredmedically necessaryin carefully selected individuals when the following Adult or Pediatric Clinical Indications criteria (whichever is applicable)andthe General Individual Selection criteria below are met.
A poor probability of survival;and
ONEof the following underlying conditions:Supported by a mechanical circulatory support (MCS) device;orSupported by an intra-aortic balloon pump (IABP);orRefractory cardiogenic shock;orDependency onintravenous (IV) inotropic support to maintain adequate organ perfusion;orSevere ischemia consistently limiting routine activity not amenable to bypass surgery or percutaneous coronary intervention (PCI);orRecurrent unstable ischemia not amenable to bypass surgery or percutaneous coronary intervention [...]
Supported by a mechanical circulatory support (MCS) device;or

ANTHEM-MP-A053845 — TRANS.00033 Heart Transplantation

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