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vperl

What An Icd Does To The Ratings System

Question

DC 7011, Ventricular Arrhythmias (Sustained)

A condition involving depolarization of the atria or ventricles, or both, that occurs before the next expected sinus beat. In other words this is a premature heartbeat. Most complain of a skipped beat, flutter or extra beats in the chest but usually disregard them until they become frequent. The cause must be found before treatment can be started. ECG is the most likely method of determining a cause.

The criteria are the same objective measurements that are used for arteriosclerotic heart disease and other heart diseases. However, there are specific provisions for a total evaluation while an Automatic Implantable Cardioverter-Defibrillator (AICD) is in place.

AICD - Automatic Implantable Cardioverter-Defibrillator - A pulse generator (smaller than a deck of cards) is implanted in the abdomen underneath the skin. Electrodes sense the rhythm of the heart and deliver a powerful shock when a life-threatening rhythm occurs (ventricular tachycardia or fibrillation). If necessary, it can give three to four additional shocks. The batteries are designed to last 4 to 5 years and deliver about 100 shocks. It originally required open-chest surgery for implantation. Now electrodes are inserted into the heart through veins. The pulse generator must be replaced (minor surgery) when batteries die. Firing may cause depression, anxiety, thoughts of dying, etc.

Uses of AICD:

    • For people at high risk for sudden death.
    • For episodes of ventricular tachycardia.
    • For those who have survived ventricular fibrillation but have not had an acute heart attack; or those who are at high risk for another episode of ventricular fibrillation.
    • For those with structural defects of the heart, like massive dilation or excessive thickening of the heart muscle.


      After implantation, recovery of normal activity is expected in 4 to 6 weeks.


      Rating Schedule:

      • For indefinite period from date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia, or; for indefinite period from date of hospital admission for ventricular aneurysmectomy, or; with an automatic implantable Cardioverter-Defibrillator (AICD) in place 100%
      • Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent 100%
      • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent 60%

      [*]Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray 30%

      [*]Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required 10%

      Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. ง 3.105(e).

      DC 7018, Implantable Cardiac Pacemakers

      An electronic device that acts in the place of the heart’s own pacemaker, the sinoatrial node, and is programmed to imitate the normal conduction sequence of the heart. They are usually surgically implanted under the skin of the chest and have wires running to the heart.

      A two-month convalescence evaluation is provided. Following that, the condition is to be rated as supraventricular arrhythmias (DC 7010), ventricular arrhythmias (DC 7011) or atrioventricular block (DC 7015). The minimum evaluation under this code following pacemaker insertion is 10%.

      A note following the rating criteria directs that Automatic Implantable Cardioverter-Defibrillators (AICDs) are to be rated under DC 7011 with an evaluation of 100%. An AICD is similar in many respects to an artificial pacemaker; however, pacemakers are usually chosen to correct a heart rhythm that is too slow (bradycardia) whereas AICDs are used to correct a heart rhythm that is too fast. AICDs are used to correct more serious heart irregularities than typical pacemakers, as described under DC 7011. People with AICDs need to be much more careful in certain situations. Because of the severity of the conditions that require an AICD, it is the only implantable pacemaker that supports the 100% evaluation.

      http://74.125.155.132/search?q=cache:fscvp...=clnk&gl=us

      Pretty sure Jim Strickland was right..... but we wait for VA decision.....

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3 answers to this question

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DC 7011, Ventricular Arrhythmias (Sustained)

A condition involving depolarization of the atria or ventricles, or both, that occurs before the next expected sinus beat. In other words this is a premature heartbeat. Most complain of a skipped beat, flutter or extra beats in the chest but usually disregard them until they become frequent. The cause must be found before treatment can be started. ECG is the most likely method of determining a cause.

The criteria are the same objective measurements that are used for arteriosclerotic heart disease and other heart diseases. However, there are specific provisions for a total evaluation while an Automatic Implantable Cardioverter-Defibrillator (AICD) is in place.

AICD - Automatic Implantable Cardioverter-Defibrillator - A pulse generator (smaller than a deck of cards) is implanted in the abdomen underneath the skin. Electrodes sense the rhythm of the heart and deliver a powerful shock when a life-threatening rhythm occurs (ventricular tachycardia or fibrillation). If necessary, it can give three to four additional shocks. The batteries are designed to last 4 to 5 years and deliver about 100 shocks. It originally required open-chest surgery for implantation. Now electrodes are inserted into the heart through veins. The pulse generator must be replaced (minor surgery) when batteries die. Firing may cause depression, anxiety, thoughts of dying, etc.

Uses of AICD:

    • For people at high risk for sudden death.
    • For episodes of ventricular tachycardia.
    • For those who have survived ventricular fibrillation but have not had an acute heart attack; or those who are at high risk for another episode of ventricular fibrillation.
    • For those with structural defects of the heart, like massive dilation or excessive thickening of the heart muscle.


      After implantation, recovery of normal activity is expected in 4 to 6 weeks.


      Rating Schedule:

      • For indefinite period from date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia, or; for indefinite period from date of hospital admission for ventricular aneurysmectomy, or; with an automatic implantable Cardioverter-Defibrillator (AICD) in place 100%
      • Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent 100%
      • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent 60%

      [*]Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray 30%

      [*]Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required 10%

      Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. ง 3.105(e).

      DC 7018, Implantable Cardiac Pacemakers

      An electronic device that acts in the place of the heart's own pacemaker, the sinoatrial node, and is programmed to imitate the normal conduction sequence of the heart. They are usually surgically implanted under the skin of the chest and have wires running to the heart.

      A two-month convalescence evaluation is provided. Following that, the condition is to be rated as supraventricular arrhythmias (DC 7010), ventricular arrhythmias (DC 7011) or atrioventricular block (DC 7015). The minimum evaluation under this code following pacemaker insertion is 10%.

      A note following the rating criteria directs that Automatic Implantable Cardioverter-Defibrillators (AICDs) are to be rated under DC 7011 with an evaluation of 100%. An AICD is similar in many respects to an artificial pacemaker; however, pacemakers are usually chosen to correct a heart rhythm that is too slow (bradycardia) whereas AICDs are used to correct a heart rhythm that is too fast. AICDs are used to correct more serious heart irregularities than typical pacemakers, as described under DC 7011. People with AICDs need to be much more careful in certain situations. Because of the severity of the conditions that require an AICD, it is the only implantable pacemaker that supports the 100% evaluation.

      http://74.125.155.132/search?q=cache:fscvp...=clnk&gl=us

      Pretty sure Jim Strickland was right..... but we wait for VA decision.....

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My husband had a heart attack in 1994, 2001 and 2004. He has a defibrillator/pacemaker implant due to IHD and a low EF. He is a Viet Nam Vet with a previous denied claim for IHD related to AO. We have filed a request to reopen the claim due to the new regs. Are you saying even with the expected percentage to be 60% anyone with a ICD will be rated 100% and be retroactive back to te original file date of 2006?

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DC 7011, Ventricular Arrhythmias (Sustained)

A condition involving depolarization of the atria or ventricles, or both, that occurs before the next expected sinus beat. In other words this is a premature heartbeat. Most complain of a skipped beat, flutter or extra beats in the chest but usually disregard them until they become frequent. The cause must be found before treatment can be started. ECG is the most likely method of determining a cause.

The criteria are the same objective measurements that are used for arteriosclerotic heart disease and other heart diseases. However, there are specific provisions for a total evaluation while an Automatic Implantable Cardioverter-Defibrillator (AICD) is in place.

AICD - Automatic Implantable Cardioverter-Defibrillator - A pulse generator (smaller than a deck of cards) is implanted in the abdomen underneath the skin. Electrodes sense the rhythm of the heart and deliver a powerful shock when a life-threatening rhythm occurs (ventricular tachycardia or fibrillation). If necessary, it can give three to four additional shocks. The batteries are designed to last 4 to 5 years and deliver about 100 shocks. It originally required open-chest surgery for implantation. Now electrodes are inserted into the heart through veins. The pulse generator must be replaced (minor surgery) when batteries die. Firing may cause depression, anxiety, thoughts of dying, etc.

Uses of AICD:

    • For people at high risk for sudden death.
    • For episodes of ventricular tachycardia.
    • For those who have survived ventricular fibrillation but have not had an acute heart attack; or those who are at high risk for another episode of ventricular fibrillation.
    • For those with structural defects of the heart, like massive dilation or excessive thickening of the heart muscle.


      After implantation, recovery of normal activity is expected in 4 to 6 weeks.


      Rating Schedule:

      • For indefinite period from date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia, or; for indefinite period from date of hospital admission for ventricular aneurysmectomy, or; with an automatic implantable Cardioverter-Defibrillator (AICD) in place 100%
      • Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent 100%
      • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent 60%

      [*]Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray 30%

      [*]Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required 10%

      Note: A rating of 100 percent shall be assigned from the date of hospital admission for initial evaluation and medical therapy for a sustained ventricular arrhythmia or for ventricular aneurysmectomy. Six months following discharge, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 C.F.R. ง 3.105(e).

      DC 7018, Implantable Cardiac Pacemakers

      An electronic device that acts in the place of the heart's own pacemaker, the sinoatrial node, and is programmed to imitate the normal conduction sequence of the heart. They are usually surgically implanted under the skin of the chest and have wires running to the heart.

      A two-month convalescence evaluation is provided. Following that, the condition is to be rated as supraventricular arrhythmias (DC 7010), ventricular arrhythmias (DC 7011) or atrioventricular block (DC 7015). The minimum evaluation under this code following pacemaker insertion is 10%.

      A note following the rating criteria directs that Automatic Implantable Cardioverter-Defibrillators (AICDs) are to be rated under DC 7011 with an evaluation of 100%. An AICD is similar in many respects to an artificial pacemaker; however, pacemakers are usually chosen to correct a heart rhythm that is too slow (bradycardia) whereas AICDs are used to correct a heart rhythm that is too fast. AICDs are used to correct more serious heart irregularities than typical pacemakers, as described under DC 7011. People with AICDs need to be much more careful in certain situations. Because of the severity of the conditions that require an AICD, it is the only implantable pacemaker that supports the 100% evaluation.

      http://74.125.155.132/search?q=cache:fscvp...=clnk&gl=us

      Pretty sure Jim Strickland was right..... but we wait for VA decision.....

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