CG-DME-55 Automated External Defibrillators for Home Use

This policy addresses automated external defibrillators (AEDs) for home use. Coverage is medically necessary only when the individual meets implantable cardioverter-defibrillator (ICD) criteria and has a documented, temporary contraindication to ICD implantation (awaiting heart transplant; prior ICD explanted for infection pending reimplantation; or a temporary condition such as active infection, postoperative recovery, or lack of vascular access), and a capable caregiver is present in the home. Not covered when these criteria are not met or when the individual has a wearable cardioverter-defibrillator.

"An automated external defibrillator (AED) for home use is consideredmedically necessaryfor an individual who meets the following criteria (A, BandC):"

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