Health Information Management

Healthcare News: CMS to cover transcatheter aortic valve replacement

JustCoding News: Outpatient, May 30, 2012

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Providers will soon be reimbursed by Medicare for a new, less-invasive aortic valve replacement procedure. Medicare Acting Administrator Marilyn Tavenner announced CMS’ decision to pay for transcatheter aortic valve replacement (TAVR) under specific conditions.

TAVR is used to treat patients whose aortic heart valves are damaged, causing the valve to narrow. Until recently, physicians performed an invasive procedure to replace the aortic valve. With TAVR, physicians are able to replace a patient’s aortic valve through a small opening in the leg.

Because TAVR technology is still new, CMS is using “coverage with evidence development,” which requires certain provider, facility, and data collection criteria to be met. For more on the specific criteria, review CMS’ decision memo.



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