G2066, Interrogation device evaluation(s), (remote) up to 30 days; implantable
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- Mandatory secondary medical director review prior to approval
- Clinical documentation confirming the presenting condition (e.g., description of syncope episode with lack of prodrome and resulting injury, or documentation of recurrent unexplained palpitations)
- Documentation supporting suspicion of a serious cardiac arrhythmia
- Document frequency, nature, and timing of symptoms to justify choice of monitoring duration/type.
Key Coverage Criteria
- Suspected silent atrial fibrillation in the setting of cryptogenic stroke when 30-day external ambulatory monitoring is inconclusive or contraindicated.
- Suspected or known ventricular arrhythmia when 30-day external ambulatory monitoring is inconclusive or contraindicated.
- History of structural or infiltrative heart disease (e.g., valvular aortic stenosis, hypertrophic cardiomyopathy, cardiac sarcoidosis, congenital heart disease) with high risk for arrhythmias (e.g., family history, symptoms, anatomy) and 30-day external ambulatory monitoring is inconclusive or contraindicated.
- Recurrent, unexplained syncope or presyncope with suspected cardiac arrhythmia, infrequent symptoms (e.g., < once per month), and 30-day external ambulatory monitoring is inconclusive or contraindicated.
- Single, abrupt episode of unexplained syncope without prodrome resulting in injury or trauma
- Significant, recurrent, unexplained palpitations
9 Active Policies
AMBETTER-CP.MP.243, Implantable Loop Recorder
BCBSIL-MED202.058, Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
BCBSMT-MED202.058, Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
BCBSNM-MED202.058, Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting
BCBSOK-MED202.058
Related Codes
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