Implantable Cardioverter Defibrillator (ICD) - (Effective Date - 2026-06-15) 7.01.06
Excellus policy 7.01.06 Implantable Cardioverter Defibrillator (ICD) has a current effective date of June 15, 2026. The 02/19/26 off-cycle update changed criteria for post cardiac arrest, structural heart disease with sustained VT, syncope of undetermined origin with a positive EP study, and unexplained syncope with sustained VT and normal LV function, and it added separate primary prevention and secondary prevention sections. The policy considers ICDs not medically necessary for incessant VT or VF, for VT or VF due to a reversible cause, and for ablation candidates with no structural heart disease.