MM10865

Coverage policy MM10865 includes implantable defibrillators (ICDs) for patients with a history of life-threatening ventricular arrhythmias, symptomatic heart failure with reduced ejection fraction, or specific familial or genetic disorders that predispose them to tachyarrhythmias. Key requirements include documented episodes of sustained ventricular tachycardia or cardiac arrest, and restrictions for recent myocardial infarctions, CABG, or PCI procedures. Limitations specify that ICDs are not covered for patients with reversible causes for past cardiac arrest or those unlikely to survive beyond a year, along with the necessity for comprehensive clinical documentation to support coverage.

"Covered for patients with a history of life-threatening ventricular arrhythmias."

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