Members with atrial fibrillation and evidence of a localized site(s) of origin when the tachycardia is drug-resistant or the member is drug- intolerant or does not desire long-term drug therapy (e.g., pulmonary vein isolation procedures) or.Atrial tachycardia, flutter, and fibrillation.The finding of dual atrio-ventricular (AV) nodal pathway physiology and atrial echoes but without AVNRT during electrophysiological study in members suspected of having AVNRT clinically.
Members with symptomatic non-paroxysmal junctional tachycardia that is drug-resistant, drugs are not tolerated, or the member does not wish to take them.Members with symptomatic atrial tachyarrhythmias who have inadequately controlled ventricular rates or.Members with symptomatic atrial tachyarrhythmias such as those above but when drugs are not tolerated or the member does not wish to take them, even though the ventricular rate can be controlled or.Members with a dual-chamber pacemaker and pacemaker-mediated tachycardia that cannot be treated effectively by drugs or by re-programming the pacemaker or.Members resuscitated from sudden cardiac death due to atrial flutter or atrial fibrillation with a rapid ventricular response in the absence of an accessory pathway or.In members who meet any of the following: This Clinical Policy Bulletin addresses cardiac catheter ablation and radioablation.Īetna considers cardiac catheter ablation procedures medically necessary for any of the following arrhythmias: Number: 0165 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References
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