64654
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Medicare Pricing
Work RVU
11.00
Facility
$559.47
Non-Facility
$559.47
Documentation Required
- No documentation requirements are specified in the provided excerpt (no required medical records, test results, or clinical documentation listed).
- Documentation that the individual remains symptomatic despite treatment with optimal medical therapy.
- Record of left ventricular ejection fraction (LVEF) measurement showing LVEF ≤35%.
- Documentation of New York Heart Association (NYHA) functional class (must be Class II or III).
Key Coverage Criteria
- Implantable carotid sinus baroreflex activation system (Barostim Neo) purported to treat resistant hypertension (RHT).
- Implantable carotid sinus baroreflex activation system (Barostim Neo) purported to treat heart failure (HF) in an individual with reduced ejection fraction (i.e., heart failure with reduced ejection fraction).
- Baroreflex activation therapy (BAT) as delivered by the Barostim Neo (described as delivering electric current to baroreceptors in the carotid sinus to initiate systemic blood pressure lowering responses and to enable the heart to increase output).
- Referenced Medicare national coverage determination: Implantable Pulmonary Artery Pressure Sensors for Heart Failure Management (NCD 20.36) — listed in the document header/table.
- Referenced National Coverage Analysis (NCA): Renal Denervation for Uncontrolled Hypertension (CAG-00470N) — listed in the document header/table.
- The Barostim Neo is US Food & Drug Administration (FDA) approved for the treatment of HF symptoms, including functional status for an individual that remains symptomatic despite treatment with optimal medical therapy.
3 Active Policies
HUMANA-TRANSCATHETER-AND-DEVICE-BASED-HEMODYNAMIC-MANAGEMENT-PROCEDURES-MA — Transcatheter and Device-Based Hemodynamic Management Procedures - Medicare Advantage
ANTHEM-SURG.00124 — SURG.00124 Carotid Sinus Baroreceptor Stimulation Devices
REGENCE-SUR183 — Baroreflex Stimulation Devices
Related Codes
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