Under NCD 20.7, the TCAR Surveillance Project does not require the study sites to get approval from the Medicare Administrative Contractors. View the CMS coverage letters detailing approval of the TCAR Surveillance Project for high-risk and standard surgical risk patients. CMS will reimburse hospitals and physicians for symptomatic and asymptomatic patients at high risk or standard risk for traditional carotid artery surgery who participate in the TCAR Surveillance Project. According to the National Coverage Determination (NCD) 20.7 for Percutaneous Transluminal Angioplasty, the TCAR Surveillance Project is an FDA-approved post-approval carotid stenting study. TCAR Surveillance ProjectĮffective September 1, 2016, hospitals participating in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) receive CMS coverage for Transcarotid Artery Revascularization (TCAR) procedures entered into the VQI Carotid Artery Stenting module. The degree of carotid artery stenosis shall be measured by duplex Doppler ultrasound or contrast tomography angiography (CTA) or magnetic resonance angiography (MRA) or carotid artery angiography and recorded in the patient’s medical records. Myocardial infarction > 72 hours and 3) shall be excluded from coverage.≥ 2 diseased coronaries with ≥ 70% stenosis.Left ventricular ejection fraction ≥ 30%.Congestive heart failure w/ NYHA class III or IV.Permanent contralateral cranial nerve injury.Significant comorbid conditions include but are not limited to: The determination that a patient is at high risk for CEA and the patient’s symptoms of carotid artery stenosis shall be available in the patient medical records prior to performing any procedure. Patients at high risk for CEA are defined as having significant comorbidities and/or anatomic risk factors (i.e., recurrent stenosis and/or previous radical neck dissection) and would be poor candidates for CEA. The following C-codes are therefore used primarily for internal tracking purposes only. TCAR and transfemoral carotid artery stenting procedures only receive CMS coverage when performed on an in-patient basis. C-Codes for the TCAR ProcedureĬ-Codes are generally used only for the outpatient setting. View information on commonly billed hospital and physician codes, Medicare National Average payment rates, and Medicare coverage for patients at high risk and standard surgical risk. Shared Decision-Making Tool for TCAR Informed Consentįor reimbursement questions about Silk Road Medical products, please contact our Health Economics & Reimbursement staff at TCAR Reimbursement Guide.Reimbursement policies and rates applicable to TCAR may be similar to those applicable to CAS. Medicare and most other insurers typically make payment for services based on fee schedules tied to CPT codes or MS-DRGs. The ICD-10-CM codes crosswalk to Medicare Severity Diagnosis Related Groups (MS‐DRG) for the purposes of hospital inpatient reimbursement. TCAR may be described by the same Current Procedural Terminology (CPT®) 1 codes and International Classification of Diseases codes (10th revision, clinical modification) 2 (ICD-10-CM) as Carotid Artery Stenting (CAS). ![]() ![]() ![]() The information provided herein is for informational purposes only and is intended to explain coverage, coding, and payment policies potentially applicable to TransCarotid Artery Revascularization (TCAR) using Silk Road Medical’s ENROUTE Transcarotid Neuroprotection (NPS) and Transcarotid Stent System (TSS).
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