National Coverage Determination (NCD)

Diagnostic Endocardial Electrical Stimulation (Pacing)


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Tracking Information

Publication Number
Manual Section Number
Manual Section Title
Diagnostic Endocardial Electrical Stimulation (Pacing)
Version Number
Effective Date of this Version

Description Information

Benefit Category
Diagnostic Services in Outpatient Hospital
Diagnostic Tests (other)
Physicians' Services

Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

Diagnostic endocardial electrical stimulation involves the detection and stimulation of cardiac electrical activity for the purpose of studying arrhythmias and abnormalities of the heart's conduction system. Intracardiac electrode catheters, intracardiac and extracardiac recordings and a stimulator device are required. From two to six multipolar electrode catheters are inserted percutaneously, usually through the femoral veins, and advanced to the heart under fluoroscopic control. Other venous or arterial routes may be employed as well. An intracardiac His bundle cardiogram is usually obtained during EES as are conventional electrocardiograms. No separate charge will be recognized for the His Bundle cardiogram. (See §20.16.)

EES is used to investigate the mechanisms, site of origin and pathways of cardiac arrhythmias as well as to select therapeutic approaches for their resolution. EES is also employed to identify patients at risk of sudden arrhythmic death. The principal use for EES is in the diagnosis and treatment of sustained ventricular tachycardia. However, it has also proven to be of value in the diagnosis and management of other complex arrhythmias, conduction defects, and after cardiac arrest.

Indications and Limitations of Coverage

Diagnostic endocardial electrical stimulation (EES), also called programmed electrical stimulation of the heart, is covered under Medicare when used for patients with severe cardiac arrhythmias.

Additional Information

Other Versions
Title Version Effective Between
Diagnostic Endocardial Electrical Stimulation (Pacing) 1 12/03/1984 - N/A You are here