Cardiac Electrophysiological Studies and Cardiac Catheter Ablation - Medicare Advantage

This policy covers cardiac electrophysiological studies (EPS/EES) and cardiac catheter ablation (radiofrequency and cryoablation), including use of 3‑D mapping systems, to evaluate and identify arrhythmogenic foci/pathways and to treat symptomatic arrhythmias. Key populations include patients with symptomatic or drug‑refractory arrhythmias (eg, paroxysmal AF), candidates for AV node ablation after failed/intolerant medical therapy, survivors of sudden cardiac death when specific arrhythmias are suspected, and select cardiomyopathy or congenital heart disease patients not eligible for ICDs; coverage is limited to cases meeting specified clinical criteria and excludes investigational/insufficient‑evidence procedures (eg, stereotactic arrhythmia radioablation, pulmonary artery denervation), with acknowledgement of procedure‑related risks.

"93799: Unlisted cardiovascular service or procedure"