National Coverage Analysis (NCA) Tracking Sheet

Ventricular Assist Devices (VADs) as a Bridge to Heart Transplantation

CAG-00162N

Issue

The Centers for Medicare and Medicaid Services (CMS) has discovered a discrepancy regarding two Coverage Issues Manual (CIM) instructions. CIM §35-87 states that Medicare does not cover the use of artificial hearts or ventricular assist devices (VAD), either as a permanent replacement for a human heart or as a temporary life-support system until a human heart becomes available for transplant (often referred to as a "bridge to transplant"). CIM §65-15 provides coverage for VAD when used as either a bridge to a heart transplant or for support of blood circulation postcardiotomy.

We are opening an NCD to correct the discrepancy in CIM §35-87 and make it consistent with CIM §65-15. We will not address changes to CIM §65-15 in this NCD.

National Coverage Determinations

Benefit Category

No Benefit Category

Requestor Information

Requestor Name Requestor Letter
Internally generated N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
07/11/2002
Expected NCA Completion Date
10/30/2002
Public Comment Period
08/12/2002 - 09/11/2002
Proposed Decision Memo Due Date
07/11/2002
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
10/30/2002

Contacts

Lead Analysts
Samantha Richardson
Lead Medical Officers
Madeline Ulrich, MD

Medicare Benefit Category Determination Date

Actions Taken

July 11, 2002

CMS is requesting public comments before any corrections are made to CIM §35-87.

October 30, 2002