- TEB is non-covered when used for patients:
- All other uses of TEB not otherwise specified remain non-covered.
- Safe and effective.
- Not experimental or investigational (exception: routine costs of qualifying clinical trial services with dates of service on or after September 19, 2000, which meet the requirements of the clinical trials NCD are considered reasonable and necessary).
- Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is:
- Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
- Furnished in a setting appropriate to the patient’s medical needs and condition.
- Ordered and furnished by qualified personnel.
- One that meets, but does not exceed, the patient’s medical need.
- At least as beneficial as an existing and available medically appropriate alternative.
Providers are reminded to refer to the long descriptors of the
Bioimpedance, cv analysis
Hypertrophic obstructive cardiomyopathy
Other primary cardiomyopathies
Secondary cardiomyopathy, unspecified
Congestive heart failure, Unspecified
Left heart failure
Systolic Heart Failure
Diastolic Heart Failure
Combined systolic and diastolic heart failure
Heart failure, unspecified
Shortness of breath
Adjustment of cardiac pacemaker
- Documentation supporting medical necessity should be legible, maintained in the patient’s medical record, and made available to Medicare upon request.
- The medical record must show that this modality contributed to the management of the patient The use of bioimpedance must be supported by documented changes in the clinical examination and provide for a level of clinical decision-making beyond the findings of the history and physical examination.
- A separate report, i.e., separate from the Evaluation and Management (E/M) service documentation, should be available for review. The report should list:
- Patient demographics including name, age, height, weight and vital signs.
- Date of the study.
- Referring physician.
- Clinical diagnosis.
- Specific reason for the study (as outlined in the “Indications and Limitations of Coverage and/or Medical Necessity” section of this policy).
- Results of the cardiac output, cardiac index, thoracic volume, systemic vascular resistance and index of contractility.
- Interpretation of the data.
- The application of the data to the listed clinical problem.
- Repeated measurements to monitor acute interventions will only be reimbursed once per day.
- Cardiac output monitoring by TEB must be ordered by the treating physician who must document that its use aids in the management of the patient.