Reimbursement

Watchman Left Atrial Appendage Closure Device Download Center

The WATCHMAN™ portal is an educational resource for use by practicing physicians and allied healthcare professionals. The WATCHMAN portal is not intended for patients or consumers.

Health economic and reimbursement information provided by Boston Scientific Corporation is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

For questions regarding WATCHMANTM Device reimbursement, please contact the Boston Scientific Reimbursement Support Line.

Email: WATCHMAN.Reimbursement@bsci.com

Boston Scientific encourages providers to submit accurate and appropriate claims for services. It is always the provider's responsibility to determine medical necessity, the proper site for delivery of any services and to submit appropriate codes, charges and modifiers for services that are rendered. Boston Scientific recommends that you consult with your payers, reimbursement specialists and/or legal counsel regarding coding, coverage and reimbursement matters. Boston Scientific does not promote the use of its products outside their FDA-approved labeling. Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. The coding options listed within this guide are commonly used codes and are not intended to be an all-inclusive list. Providers are responsible for making appropriate decisions related to coding and reimbursement submissions. We recommend consulting your relevant manuals for appropriate coding options.
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WATCHMAN FLX LAAC Device Reimbursement Guide

File Type: PDF
This comprehensive guide provides an overview of the coding, coverage and payment landscape for the WATCHMAN FLX LAAC Device system.
 

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WATCHMAN FLX LAAC Device TEE and CT Scan Reimbursement Rates

File Type: PDF
Quick reference guide highlighting the current coding and physician reimbursement rates for Transesophageal Echocardiography (TEE) and Computed Tomography (CT) Scan for the WATCHMAN FLX LAAC Device.

 

WATCHMAN Payer List

WATCHMAN FLX LAAC Device Payer List

File Type: PDF
A full list of all private and public plans that cover the WATCHMAN FLX LAAC Device.
 

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Supporting Patient Access to the WATCHMAN FLX LAAC Device Therapy

File Type: PDF
The following information and prior authorization assessment document is provided to assist providers in addressing patient-specific insurance requirements for the WATCHMAN FLX LAAC Device procedure. The assessment document is intended to be submitted with the patient’s clinical medical notes for insurance prior authorizations.
 

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WATCHMAN Assessment Tool

File Type: PDF
The WATCHMAN FLX LAAC Device Assessment Form is a prior authorization cover sheet intended to assist with prior authorizations of the WM FLX LAAC device procedures. This checklist is intended to be used to support prior authorizations in addition to submitting patient’s medical notes.
 

Shared Decision Making Brochure

Shared Decision Making Brochure

File Type: PDF
Brochure to overview shared decision making, a collaborative process that allows patients and their providers to make health care treatment decisions together.

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WATCHMAN FLX LAAC Device Sample Appeals Template

File Type: Word
Template to assist providers with appealing denials by utilizing the criteria of the NCD for percutaneous LAAC therapy in referencing patient’s eligibility.
 

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WATCHMAN FLX LAAC Device Sample Letter of Medical Necessity

File Type: Word
Template to assist with prior authorization of WATCHMAN FLX LAAC Device procedures based on utilizing the criteria of the NCD.
 

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WATCHMAN FLX LAAC Device Medicare Advantage Sample Appeal Template

File Type: Word
Template to assist providers with appealing Medicare Advantage denials by utilizing the criteria of the NCD for percutaneous LAAC therapy in referencing patient’s eligibility.
 

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WATCHMAN FLX LAAC Device Peer-to-Peer Appeal Guide

File Type: PDF
Quick reference guide intended to support peer-to-peer appeal conversations between the implanting physician and health plan Medical Directors following denial of coverage for the WATCHMAN FLX LAAC Device.
 

WATCHMAN Coverage Clinical Evidence Summary

WATCHMAN Device Approval/Coverage Status & Clinical Evidence Summary

File Type: PDF
This document has the FDA/coverage status and clinical evidence summary. This comprehensive information is intended to be used to support the prior authorization, appeal, and peer to peer processes.

WATCHMAN Claim Form 1500

WATCHMAN FLX LAAC Device Claim Form 1500

File Type: PDF
Use this form to help with submitting individual professional service reimbursement claims for WATCHMAN FLX LAAC Device procedures.

WATCHMAN Facility Claim Form

WATCHMAN FLX LAAC Device CMS Inpatient UB-04 Claim Form

File Type: PDF
Use this form to help with submitting hospital service reimbursement claims for WATCHMAN FLX LAAC Device procedures.
 

 
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