medicare and pacemakers two

See URL     

https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=267%20

 

If the pacemaker is for non reversable case it is allowed.  But I have been on sotalol since 1980s.  This is not really reversable bur Menicare considers it to be reversable so no dice.

 

Curiousd

 

2 Comments

You've actually been refused?

by AgentX86 - 2019-11-02 21:03:06

It would seem to me that the sotalol is needed.

At one point my EP's plan was to implant a pacemaker to keep my heat rate up while increasing sotalol/metoprolol.  The problem didn't come up because the Sotalol damaged my SI node (asystoles) before I had to cross that bridge. As long as I needed the PM anyway, I chose the AV ablation to take care of the flutter permanently (all of the drugs were becoming ineffective). I'm not on Medicare, though (this week).

It would be interesting ...

by donr - 2019-11-03 12:29:33


...to see your diagnosis.  How on earth can you have a need Sotalol, a Class III antiarrhythmic for 30 - 40 years & the situation be reversible.  You gave ZERO info in your bio sketch.   You have got to be close to 95 based on what we know.  If you were NOT on Medicare when this all started, Medicare would have had no say on whether or not you had a PM implanted.  You are also dead wrong about what Medicare can/cannot do.  Our daughter is a PCP and treats all sorts of people for cash payment.  There are just limitations on how much she can charge Medicare eligible patients usig any sort of dual fee structure.  It is just extremely complicated, not impossible.

\Donr

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