Permanent cardiac pacing in the era of peer review. The acceptable indications and the necessary documentation

Physicians have rightly become cautious regarding prescription of cardiac pacemaker implantation because of adverse publicity charging overuse of the devices and the advent of Medicare-required peer review for reimbursement. Although the physician performing the implant procedure is ultimately responsible, the referring physician can lay the groundwork for a 'good case' and often is the key to ensuring reimbursement. The authors describe the acceptable indications for permanent pacing as stipulated by the May 1985 Medicare guidelines, explain the review process itself, and outline the required documentation for reimbursement approval.