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
Lead Medical Officers

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