What conditions must be met for ICD reimbursement according to FDA and CMS?

The correct answer focuses on the necessity for confirmed structural heart disease and spontaneous ventricular tachycardia (VT) to qualify for implantable cardioverter-defibrillator (ICD) reimbursement as per FDA and CMS guidelines. This is critical because the presence of structural heart disease provides a clear indication of an underlying cardiac condition that may lead to life-threatening arrhythmias, making the implantation of an ICD essential for preventative purposes. Spontaneous VT signifies that the patient is at risk for sudden cardiac death, warranting monitoring and intervention provided by the ICD.

Specifically, confirmed structural heart disease is typically characterized by conditions such as ischemic cardiomyopathy or non-ischemic cardiomyopathy, which reflect heart dysfunction. The presence of spontaneous VT indicates that the heart is prone to dangerous electrical activity that needs to be managed proactively.

While other choices may mention possible clinical scenarios or conditions, they do not meet the specific criteria established for ICD reimbursement. For example, simply having persistent NYHA class 4 symptoms alone does not confirm the presence of structural heart disease nor does it specifically indicate the risk for arrhythmias that warrants ICD use. Admission for coronary revascularization may be relevant in the context of treating coronary artery disease but does not directly support the