Percutaneous Left Atrial Appendage Closure for Stroke Prevention

This policy covers percutaneous left atrial appendage (LAA) closure using FDA‑approved devices (WATCHMAN, WATCHMAN FLX, Amplatzer Amulet) to reduce stroke risk. Coverage is limited to adults with non‑valvular atrial fibrillation at increased stroke risk (e.g., elevated CHADS2/CHA2DS2‑VASc) who have contraindications to or unacceptable bleeding risk from long‑term oral anticoagulation but can tolerate short‑term anticoagulation; it is not covered as a substitute when anticoagulation is tolerated, is limited to the specified FDA‑approved devices, and carries procedural risks (early adverse events ≈10%, including pericardial bleeding), with coverage subject to plan and Medicare/Medicaid rules.

"FDA‑approved percutaneous LAA occlusion devices are medically necessary to reduce stroke risk in adults with non‑valvular atrial fibrillation when all criteria below are met."