Implantable Loop Recorder

This policy covers implantable loop recorders (implantable cardiac monitors) for long‑term ambulatory ECG monitoring to diagnose, characterize, and guide management of suspected or known cardiac arrhythmias. Coverage is limited to patients with infrequent symptoms or high‑risk conditions—e.g., suspected silent atrial fibrillation after cryptogenic stroke when 30‑day external monitoring is inconclusive or contraindicated, suspected/known ventricular arrhythmia, structural/infiltrative heart disease, recurrent unexplained syncope, or significant palpitations—and for replacement only if the device is nonfunctional and out of warranty; prior noninvasive/30‑day external monitoring is required, it is not indicated for frequent symptoms (≥ once/month) or when external monitoring is feasible/conclusive, evidence is generally restricted to patients >40 years, and it does not apply when a stroke cause is known or anticoagulation is contraindicated.

"Suspected silent atrial fibrillation in the setting of cryptogenic stroke when 30-day external ambulatory monitoring is inconclusive or contraindicated."