Is anyone receiving full denials with cases where the planned procedure was Watchman insertion, but it ended up being aborted and Watchman was removed. We are not winning our appeals to show that the physician needed to remove the watchman.
We did followed the guidelines from Watchman. " A 20 mm Watchman delivery system was then advanced under fluoroscopy till the foot of the watchman device was almost at the tip of the outer delivery sheath in the left atrial appendage. The outer sheath was then slowly withdrawn until the device was seen to expand in the appendage. After multiple attempts of deployment using different angles and maneuver significant shoulder of >50% identified on both TEE and angiogram. Therefore the watchman was removed after recapturing. The sheath was removed, and per close deployed."
Comments
did you follow the billing guidelines for this scenario?
And why was it aborted? Some will not allow billing if you should have anticipated it was not going to work like no pre-op ECHO to check LA dimensions
We did followed the guidelines from Watchman. " A 20 mm Watchman delivery system was then advanced under fluoroscopy till the foot of the watchman device was almost at the tip of the outer delivery sheath in the left atrial appendage. The outer sheath was then slowly withdrawn until the device was seen to expand in the appendage. After multiple attempts of deployment using different angles and maneuver significant shoulder of >50% identified on both TEE and angiogram. Therefore the watchman was removed after recapturing. The sheath was removed, and per close deployed."
Interesting. Well, then the payer needs to get with the system. Appeal, appeal, appeal, and call Boston Scientific and ask for help and advocacy.