Reimbursement

Watchman Left Atrial Appendage Closure Device Download Center

The WATCHMAN™ portal is an educational service 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.

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.

WATCHMAN Reimbursement Guide

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

Importance of Documentation

File Type: PDF
This guide stresses the importance of documentation in capturing the appropriate acuity level for patients considered WATCHMAN candidates. It helps provide an overview of the common complications and comorbidities that assist with the MS-DRG assignment based on patient medical appropriateness.

WATCHMAN Importance of Appropriate Charging Guide

File Type: PDF
This guide provides education to hospitals on the importance of appropriate charging practices for high cost implantable devices such as the WATCHMAN LAAC Device.

WATCHMAN Claim Form 1500

File Type: PDF
This document is intended to aid individuals submitting professional service reimbursement claims for the WATCHMAN procedure.

WATCHMAN CMS Inpatient UB-04 Claim Form

File Type: PDF
This document is intended to aid hospitals submitting reimbursement claims for the WATCHMAN procedure.
 

WATCHMAN Private Payer Dashboard

File Type: PDF
This document is intended to provide a Private Payer list that covers WATCHMAN.
 

Supporting Patient Access to the WATCHMAN LAAC Therapy

File Type: PDF
The following information is provided to assist providers in addressing patient-specific insurance requirements for the WATCHMAN LAAC implant procedure and associated services.

WATCHMAN Provider Intake Form

File Type: PDF
This document is intended to assist with prior-authorization of the WATCHMAN therapy.

WATCHMAN Sample Prior Authorization Letter

File Type: Word Document
Template to assist with prior authorization of the WATCHMAN Therapy based on utilizing the criteria of the NCD for percutaneous LAAC therapy.

WATCHMAN Sample Letter of Medical Necessity

File Type: Word Document
Template to assist with prior authorization of the WATCHMAN Therapy based on utilizing the criteria of the NCD.

WATCHMAN Sample Appeals Template

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

 

WATCHMAN Physician 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 (LAAC) Device.
 

WATCHMAN Approval/Coverage Status & Clinical Evidence Summary

File Type: Word Document
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.

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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