CMS Pub. 100-04, ch. 32, § 320.3.4

Effective April 1, 2013, claims for replacement of accessories and supplies for VADs implanted in patients who were

not eligible for coverage under Medicare Part A or had other insurance that paid for the device and hospital stay at the

time that the device was implanted, but are now eligible for coverage of the replacement supplies and accessories

under Part B, should be submitted using HCPCS code Q0509. Those claims will be manually reviewed.

In rare instances it may be appropriate to pay for replacement of supplies and accessories for

external VADs used by patient who are discharged from the hospital. In addition, in some rare

instances, it may be necessary for a patient to have an emergency back-up controller for an

external VAD. Coverage of these items is at the discretion of the contractor. Claims for

replacement of supplies and accessories used with an external VAD that are furnished by

suppliers should be billed to the Part B MACs. Claims for replacement of supplies and

accessories used with an external VAD that are furnished by hospitals and other providers

should be billed to the Part AMACs. Effective April 1, 2013, these items should be billed

using code Q0507 so that the claims can be manually reviewed.

Claims for replacement supplies or accessories used with VADs that do not have specific

HCPCS codes and do not meet the criteria of codes Q0507 and Q0509 should be billed using

code Q0508.

Claims Coding

HCPCS Definition Effective

Date

Q0507 Miscellaneous Supply Or Accessory For Use With An

External Ventricular Assist Device

April 1,

2013

Q0508 Miscellaneous Supply or Accessory For Use With An

Implanted Ventricular Assist Device April 1,

2013

Q0509 Miscellaneous Supply Or Accessory For Use With Any

Implanted Ventricular Assist Device For Which Payment

Was Not Made Under Medicare Part A

April 1,

2013

Q0480:Driver for use with pneumatic ventricular assist device, replacement only

Q0481:Microprocessor control unit for use with electric ventricular assist device, replacement only

Q0482:Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement

only

Q0483:Monitor/display module for use with electric ventricular assist device, replacement only

Q0484:Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0485:Monitor control cable for use with electric ventricular assist device, replacement only

Q0486:Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only

Q0487:Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only

Q0488:Power pack base for use with electric ventricular assist device, replacement only

Q0489:Power pack base for use with electric/pneumatic ventricular assist device, replacement only

Q0490:Emergency power source for use with electric ventricular assist device, replacement only

Q0491:Emergency power source for use with electric/pneumatic ventricular assist device, replacement only

Q0492:Emergency power supply cable for use with electric ventricular assist device, replacement only

Q0493:Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only

Q0494:Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0495:Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0496:Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement

only

Q0497:Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0498:Holster for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0499:Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement

only

Q0500:Filters for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0501:Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only

Q0502:Mobility cart for pneumatic ventricular assist device, replacement only

Q0503:Battery for pneumatic ventricular assist device, replacement only, each

Q0504:Power adapter for pneumatic ventricular assist device, replacement only, vehicle type

Q0506:Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only

NOTE: When determined to be medically necessary, dressings used with VADs are covered under the prosthetic device

benefit as a supply necessary for the effective use of the VAD/prosthetic device. Claims for dressings necessary for the

effective use of a VAD should be billed using the appropriate miscellaneous VAD supply code, depending upon whether

the patient was eligible for coverage under Medicare Part A at the time that the VAD was implanted. The claims

processing jurisdiction for dressings used with VADs is identical to that of other VAD replacement supplies and

accessories and does not fall under Durable Medical Equipment MAC jurisdiction.