Cardiovascular Procedures, Devices and Therapies
These are the AT&T CarePlus covered procedures and services effective January 1, 2019. Prior approval is required, please contact CarePlus customer care at 1-877-261-3340.
For treatment of hypervolemia due to congestive heart failure (CHF).
Artificial Heart or Ventricular Assist Devices
For destination therapy, for example:
- Mini-Ventricular Assist Device (Mini-VAD)
- 2nd Generation VAD (e.g., Heartmate II, III, Jarvik 2000, Abiocor, DeBakey, LionHeart)
Note: This service is covered under the Base Medical Program when used as a bridge to transplant and is also a Designated Emergency Covered Procedure.
Barostim Neo™ Implantable Pulse Generator for Heart Failure
A pulse generator that is implanted below the collar bone and connected to a lead that is attached to the carotid artery in the neck. The device senses how blood is flowing through the carotid artery and relays information to the brain by delivering electrical impulses to arteries in the neck. To be eligible the patient must be diagnosed with heart failure — based on Food and Drug Administration Guidelines — and have a prescription from a Physician. Not for patients indicated for Cardiac Resynchronization Therapy according to AHA/ACC/ESC guidelines. Coverage includes the placement procedure and the device as well as parts and battery replacement.
CADence™ – Tests using in-office handheld device for rapid identification of patients with significant risk from Coronary Artery Disease (CAD). Note: This service is effective 4/1/18
Cardiac Contractility Modulation – An implantable device to treat Chronic Heart Failure patients who are not eligible for Cardiac Resynchoronization Therapy. The device controls the force of a heartbeat as opposed to the rhythm.
Continuous Remote Monitoring for Management of Heart Failure
Includes coverage of services to “read-out” and utilize data generated by previously implanted cardiac devices.
Coronary Sinus Reducer Stent
For patients with refractory angina who are not candidates for conventional revascularization procedures.
C-Pulse Heart Assist System
To reduce cardiac workload in heart failure patients.
Crossing and Re-entry Catheter-Based System
For coronary chronic total occlusion (CTO).
Implantable Wireless Monitor
For management of chronic heart failure in patients with NYHA Class III heart failure.
Gene Transfer Therapy
For treatment of cardiovascular disease.
A wearable cardioverter defibrillator for children at risk for sudden cardiac arrest who are not candidates for implantable devices.
Micra Transcatheter Pacing System (TPS)
A “leadless” cardiac pacemaker that is implanted directly into the right ventricle.
Minimally Invasive, Percutaneous Repair of Mitral Valve Regurgitation
For example, MitraClip® catheter-based surgical system.
Muscle Tissue Replacement (Stem Cell Transplant)
For treatment of:
- Heart Failure
- Ischemic Heart Disease
Outpatient Mobile Cardiovascular Telemetry
For management of cardiac arrhythmia.
Note: Only for participants who do not have coverage for this service under their Base Medical Program.
Patent Foramen Ovale (PFO) Closure Devices
- For prevention of migraine headaches.
- For prevention of strokes.
Pediatric Artificial Mitral Valve
For use as a last resort in children diagnosed with mitral valve disease.
Pericardial Reconstruction using CorMatrix (ECM)
To repair the pericardium following open heart surgery.
Transesophageal Echocardiography (TEE)
For monitoring patients in the CICU following heart surgery.
Watchman® Left Atrial Appendage (LAA) Closure Technology
For atrial fibrillation (AFIB).