NCA - Implantable Cardioverter Defibrillators (ICDs) (CAG-00157N)

Coverage for implantable cardioverter defibrillators (ICDs) is available for patients with life-threatening ventricular arrhythmias, a history of myocardial infarction, and certain neurological symptoms, among other specific conditions. Key requirements include proper documentation of medical necessity, prior authorization, and that myocardial infarctions occurred more than 4 weeks prior to ICD insertion. Limitations exclude coverage for atrial fibrillation or flutter, routine follow-ups, and non-life-threatening arrhythmias, with only one comprehensive evaluation allowed per patient every 12 months.

"Implantable cardioverter defibrillators are covered for patients who have life-threatening ventricular arrhythmias."

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