Billing and Coding: Single Chamber and Dual Chamber Permanent Cardiac Pacemakers – Coding and Billing

CMS covers implantation of single- and dual-chamber permanent cardiac pacemakers as reasonable and necessary for non‑reversible symptomatic bradycardia due to sinus node dysfunction or second‑/third‑degree AV block and does not support use for reversible or asymptomatic bradycardia. Key requirements include documentation that symptoms are directly attributable to heart rate <60 bpm (e.g., syncope, seizures) and adherence to CMS NCD 20.8.3 coding and billing instructions as implemented by local Medicare Administrative Contractors.