CMS will now cover MRI for Medicare beneficiaries with implanted pacemakers, implantable cardioverter defibrillators, cardiac resynchronization therapy pacemakers, or cardiac resynchronization therapy defibrillator systems. The final rule updates a proposal the agency released on January 11.
CMS said it will reimburse for MRI exams conducted with 1.5-tesla units in patients with intact cardiac devices. The new guidance discards a proposal in the January memo that patients not be pacemaker-dependent, as well as the rule that patients must wait six weeks after device implantation or surgical modification before undergoing MRI.
The guidance includes a checklist for MRI exams in patients with implanted cardiac devices:
- Assess the patient to identify the presence of implanted devices.
- Communicate benefits and harms of MRI to the patient.
- Program the implanted device appropriately based on the device and patient characteristics.
- Supervise the exam with a qualified physician, nurse practitioner, or physician assistant.
- Observe patients throughout the exam.
- Provide an advanced cardiac life support provider throughout the exam.
- Establish a discharge plan that includes evaluation of the patient and the implanted device.
"We determined that the evidence is sufficient to conclude that MRI for Medicare beneficiaries with an implanted pacemaker, implantable cardioverter defibrillator, cardiac resynchronization therapy pacemaker, or cardiac resynchronization therapy defibrillator is reasonable and necessary for the diagnosis or treatment of illness or injury," CMS said.
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