Subcutaneous Implantable Defibrillator Receives Favorable Coding And Payment Designations For 2015

New CPT Category I Code Facilitates Processing for U.S. Hospitals and Physicians

Boston Scientific Corporation announced that its subcutaneous implantable defibrillator (S-ICD System™) will have designated Current Procedural Terminology (CPT®) Category I codes by the American Medical Association (AMA), effective January 1, 2015. The AMA CPT coding system provides U.S. physicians and hospitals with a uniform process for coding medical services. By definition, the CPT I category includes procedures that are widely performed and consistent with contemporary medical practice.

Also effective January 1, 2015, the Medicare hospital outpatient payment rate for implanting the S-ICD System will increase by 23 percent. Additionally, Aetna recently joined several other private health plans by broadening its coverage for the S-ICD System to all patients who meet the criteria for an ICD and are not contraindicated.

"The S-ICD System is an advanced, less invasive option for patients at risk of sudden cardiac arrest," said Michael Gold, professor of medicine and director of cardiology, Medical University of South Carolina. "The new CPT categorization establishes more predictable coding processes for hospitals and physicians when implanting the S-ICD System.  This change should improve patient access to this important therapy."

The S-ICD System may offer certain groups of patients an alternative to more invasive transvenous ICDs.  As the world's least invasive implantable defibrillator, the S-ICD System provides protection for patients at risk of sudden cardiac arrest while leaving the heart and blood vessels untouched.

"These important milestones will facilitate payment processing for both physicians and hospitals," said Kenneth Stein, chief medical officer of Rhythm Management at Boston Scientific.  "Along with the favorable published safety and efficacy data in peer-reviewed journals, these code and payment changes will further enable rapid acceptance of this ground-breaking therapy by the medical community."

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