Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 203 - Physician Services
Chapter 4 - Surgery
Rule 23-203-4.21 - Ventricular Assist Devices (VAD)
Universal Citation: MS Code of Rules 23-203-4.21
Current through September 24, 2024
A. Medicaid covers medically necessary procedures for the insertion or removal of FDA-approved ventricular assist devices (VAD) in accordance with its FDA approved uses as follows:
1. Post-cardiotomy procedures for
insertion/removal of a VAD performed during the period following open-heart
surgery.
2. Bridge-to-transplant
procedures for insertion/removal of a VAD performed during the period prior to
heart transplant when the patient is at imminent risk of dying before donor
heart procurement.
3. Destination
therapy procedures for insertion/removal of a VAD performed as a permanent
mechanical cardiac support for individuals with severe New York Heart
Association (NYHA) Class IV heart failure, and who are not eligible for heart
transplantation.
B. Medicaid does not cover procedures using non-FDA approved devices and/or done for indications other than those approved by the FDA including, but not limited to:
1. Procedures using devices that are
considered experimental, investigational, or part of clinical trials.
2. Procedures for replacement of the human
heart with an artificial heart.
C. Medicaid does not allow separate reimbursement for the ventricular devices.
Miss. Code Ann. § 43-13-121
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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