Compliance Question of the Week

Cardiology - For the Week of March 24, 2014

Question:

Will Medicare pay for cardiac catheterizations performed in a non-hospital setting?

Answer:

There is no longer a national coverage determination (NCD) for cardiac catheterizations performed in a non-hospital setting. In January 2006, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 46 (CR 4280) in which it stated the following. “In the absence of an NCD on cardiac catheterization in other than a hospital setting, coverage is determined by the local Medicare contractor.” This policy went into effect on January 12, 2006. 

(For a copy of this transmittal, search for R46NCD athttp://www.cms.hhs.gov/Transmittals/2006TransN/list.asp#TopOfPage.)

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