Billing and Coding: Percutaneous Ventricular Assist Device

Percutaneous ventricular assist devices are covered only for three life‑threatening situations — cardiogenic shock (R57.0), severe decompensated heart failure with threatening multi‑organ failure (I50.21/I50.23/I50.41/I50.43/I97.110/I97.111/I97.130/I97.131), or intraoperative/postoperative circulatory complications (I97.790/I97.791/I97.88/I97.89) — when intraaortic balloon pump (IABP) is not expected to be sufficient. Coverage requires medical record documentation of the qualifying ICD‑10 code and explicit documentation that IABP is not expected to be sufficient; no frequency limits are specified.

"Percutaneous endovascular cardiac assist device is covered for cardiogenic shock (ICD-10-CM R57."

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