SCAI has sent a joint letter with the Heart Rhythm Society and the American College of Cardiology requesting that the Centers for Medicare and Medicaid Services (CMS) provide clarification to the shared decision making provision of the NCD for LAAC. SCAI has been notified of recent denials when the shared decision making is performed by another interventional cardiologist or electrophysiologist. SCAI has requested clarification of our understanding that a non-implanting interventional cardiologist or electrophysiologist may perform the shared decision making service. SCAI awaits a response from CMS.