Transcatheter percutaneous cardiac occlusion devices are for use in minimally invasive repair of cardiac septal defects. These defects can be congenital or acquired. These devices offer an alternative to conventional open heart surgery.
A percutaneous septal occlusion device may be considered medically necessary for ANY ONE of following cardiac septal defects:
Devices for transcatheter percutaneous closure of cardiac septal defects must be U.S. Food and Drug Administration (FDA) approved and used according to the labeled indications.
All other devices or uses are considered experimental and investigational E/I and, therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature.
Transcatheter closure of patent foramen ovale (PFO) with a FDA approved device may be considered medically necessary in individuals 18 years of age or older, with a history of ischemic stroke presumed to be secondary to a paradoxical embolism, following a negative workup for other causes of ischemic stroke.
All other devices or uses are considered E/I and, therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature.
Covered Diagnosis Codes for Procedure Codes 93580, 93581 and 93582