Criteria
In the ambulatory care and outpatient settings, cardiac hemodynamic monitoring devices for the management of heart failure utilizing thoracic bioimpedance, inert gas rebreathing, arterial pressure during Valsalva maneuver, and implantable direct pressure monitoring of the pulmonary artery is considered experimental/investigational and, therefore, non-covered.
Scientific evidence has not shown that those technologies improve individual outcomes, nor have the data shown long term effectiveness or safety.
Non-Covered Devices:
Noninvasive Thoracic Impedance Plethysmography Device
- TEBCO® (Thoracic Electrical Bioimpedance Cardiac Output)
- BioZ ® Thoracic Impedance Plethysmograph
- IQ™ System Cardiac Output Monitor
- Sorba Steorra® Non-Invasive Impedance Cardiography
- Zoe® Fluid Status Monitor
- Cheetah NICOM® system
- Physioflow® Signal Morphology-based Impedance Cardiography (SM-ICG™)
Noninvasive Left Ventricular End Diastolic Pressure (LVEDP) Measurement Devices
- VeriCor® - Promote®
- LAP System®
- HeartPOD™
Implantable Pulmonary Artery Pressure Measurement Devices
Inert Gas Rebreathing Device
- Innocor® -Inert Gas Rebreathing
Procedure Codes
| C2624 | 33289 | 93264 | 93701 | 93799 |
