LCD/NCD Portal

NCD160.6

 

CAROTID SINUS NERVE STIMULATOR

 

 

Effective Date of this Version

• This is a longstanding national coverage determination.

• The effective date of this version has not been posted.

 

Benefit Category

• Prosthetic Devices

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

 

Indications and Limitations of Coverage

• Implantation of the carotid sinus nerve stimulator is indicated for relief of angina pectoris in carefully selected patients:

 Who are refractory to medical therapy.

AND

 Who after undergoing coronary angiography study either are poor candidates for or refuse to have coronary bypass surgery.

o In such cases, Medicare reimbursement may be made for this device and for the related services required for its implantation.

• However, the use of the carotid sinus nerve stimulator in the treatment of paroxysmal supraventricular tachycardia is considered investigational and is not in common use by the medical community.

o The device and related services in such cases CANNOT be considered as reasonable and necessary for the treatment of an illness or injury or to improve the functioning of a malformed body member as required by §1862(a)(1) of the Act.

 

Cross Reference

• The Medicare Benefit Policy Manual, Chapter 15,

 

 

Medicare NCD Link