Billing and Coding: Percutaneous Ventricular Assist Device

Percutaneous endovascular ventricular assist device placement is covered when documentation shows one of three life‑threatening scenarios — cardiogenic shock (R57.0), severe decompensated heart failure with threatening multi‑organ failure (specified I50.x and I97.1xx codes), or intra/postoperative circulatory complications (specified I97.7x/I97.8x codes) — and when IABP is not expected to be sufficient. For Part A inpatient services, use ICD‑10‑PCS codes 5A02116, 5A0211D, 5A02216, or 5A0221D and bill on the UB‑04; lack of documentation of these criteria or when IABP would be sufficient are exclusions.

"Percutaneous endovascular cardiac assist device is covered for cardiogenic shock when external counterpulsation (IABP) is not expected to be sufficient."

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