NCA - Implantable Defibrillators (CAG-00157R2)

Coverage for implantable defibrillators is provided for patients with a history of life-threatening ventricular arrhythmias, certain cardiomyopathies, and a reduced ejection fraction (≤ 30%) who meet specific clinical criteria and can give informed consent. Important limitations include the exclusion of patients with New York Heart Association classification IV, those who do not meet defined criteria, and services deemed not medically necessary. Coverage is also contingent on clinical documentation of arrhythmias and ejection fraction, and primary prevention may be covered if the patient is part of an approved clinical trial.

"Implantable defibrillators are covered for patients with a history of life-threatening ventricular arrhythmias."

Sign up to see full coverage criteria, indications, and limitations.