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Electrical Bioimpedance for Cardiac Output Monitoring, also known as impedance cardiography and thoracic electrical bioimpedance (TEB), is a diagnostic method that non-invasively measures cardiac output. In 1999, the Centers for Medicare & Medicaid Services (CMS) issued a national coverage decision (Coverage Issues Manual 50-54) for TEB for six indications. We have been asked to reevaluate the scope of the existing policy and to consider an additional indication, the management of hypertension. Our decision may take the form of continuing the current policy, noncoverage, limiting coverage, or expanding coverage. In the interim, the current coverage policy remains in force until a new policy decision, if any, is finalized based on our reconsideration. A new policy would be prospective and would not call into question the legitimacy of the claims paid for under the old policy.
Download Technology Assessment [PDF, 1MB].
January 2, 2003
A technical error in the technology assessment on Thoracic Electrical Bioimpedance has been identified. The following text should replace the text beginning at the first word of line 1165 (page 61) through the end of line 1172:
The authors commented that the specialist care group was comprised of nationally certified hypertension specialists with special expertise in the treatment of resistant hypertension (it should also be noted that the TEB group was treated by a physician who as a member of the Division of Hypertension and Internal Medicine at the Mayo Clinic was likely to be more expert in treating hypertension than a typical clinician in primary care), and suggested that monitoring with TEB would have a greater benefit when the alternative was management with a community physician. However, it is also possible that the small improvement in the hemodynamic monitoring group was due not only to the use of TEB, but to correct application by the treating physician of the algorithm in the authors' Table 1 that guided the use of TEB in this application. Before it could be known what the benefit of TEB would be in community practice, with treatment decisions made by generalists, the ability of generalists to learn and apply this algorithm in conjunction with TEB would need to be demonstrated and evaluated.
This change does not affect the conclusions of the technology assessment.