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CMS National Coverage Determination
for Microvolt T-Wave Alternans™ Testing Using the Analytic
Spectral Method®
Using the Analytic Spectral Method®
On March 21, 2006, the
Centers for Medicare and Medicaid
Services (CMS) issued a decision memo stating...
“Microvolt T-Wave Alternans diagnostic
testing is covered for the evaluation of patients at risk
for sudden cardiac death, only when the spectral analytic
method is used.”
Read the complete decision memo.
Who should be tested?
Per the NCD, MTWA testing is reasonable and necessary for the evaluation of Medicare patients at risk of sudden cardiac death (SCD).
Who are the patients at risk?
- Previous heart attack victims
50-75% of people who die from SCD have
suffered a previous infarct.
80% of SCD victims have signs and/or
symptoms of coronary artery disease (CAD).
In people diagnosed with heart failure, sudden cardiac death occurs at 6-9 times the rate of the general population.
Reduced left ventricular ejection fraction (LVEF) is one of the most significant risk factors for overall mortality and sudden cardiac death.
Although syncope is usually benign, it may be a symptom of serious cardiac disease and can predispose individuals to sudden death.
How is Medicare billed for the MTWA Test?
Microvolt T-Wave Alternans
for assessment of ventricular arrhythmias
- Use ICD-9-CM
Diagnosis Codes
For a listing of recommended ICD-9-CM Diagnosis codes
typically associated with risk of sudden cardiac death
that support MTWA testing click here.
How much does Medicare pay for the MTWA test?
- The 2010 national average for
MTWA testing (CPT Code 93025) is $196.71. Actual reimbursement
varies by geographical
region
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