Surgical Left Atrial Appendage Occlusion Devices for Stroke Prevention in Atrial Fibrillation

This policy covers surgical left atrial appendage (LAA) occlusion — including excision and epicardial clipping such as the AtriClip — for stroke prevention in patients with atrial fibrillation, especially when performed concomitantly with a Maze or other cardiac surgical procedure or as an alternative for those with contraindication, intolerance, or poor adherence to long‑term anticoagulation. Coverage is limited to LAA exclusion performed under direct visualization during concomitant cardiac surgery (not as a standalone or percutaneous procedure), with anticoagulation remaining first‑line therapy and surgical LAA occlusion reserved when anticoagulation is unsuitable.

"Surgical closure of the left atrial appendage (including excision and epicardial clipping such as AtriClip) is considered medically necessary only when performed concomitantly with a Maze procedure..."