Ventricular Assist Devices (VAD)

Ventricular Assist Devices (VAD) 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.