NCA - Implantable Defibrillators (CAG-00157R3)

Coverage for implantable defibrillators is provided for patients with a history of cardiac arrest, significant left ventricular dysfunction (LVEF ≤ 35%), and specific heart failure classifications, including ischemic and nonischemic dilated cardiomyopathy. Key requirements include documentation of myocardial infarction and ventricular arrhythmias, and patients must give informed consent. Limitations apply, excluding coverage for pregnant patients, those with substantial comorbidities, and certain recent cardiac procedures, as well as patients unable to meet specific clinical criteria.

"Medically necessary for patients with a history of cardiac arrest due to ventricular fibrillation."

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