Implant code ?21390

[codedog]

Hello ASC coders ,

I think the ASC where I work at may have to eat this cost. First let me say this is a MEDICAID insurance.

Doc did A procedure of OPEN REDUCTION of RIGHT ORBITAL fRACTURE with ALLOPLASTIC IMPLANT . cpt code 21390 is the code. Now it states in THE CPT code book
WITH IMPLANT . So I code it as 21390 rt with dx code 802.6.
They also have an invoice attached to it stating how much for the implant -$1949.00
Again this is a MEDICAID ONLY
IS there A certain implant code I can use also. Idont think i can, maybe I am over looking something. I know Medicare ONLY PAYS 1721.88 ON THIS procedure , and correct me if I'am AM wrong, I dont see MEDICAID paying close to this amount.
ANY suggestions please .
and wHAT IF WAS blue cross -?

[ASC CODER]

L8610

It has a N1 indicator for Medicare.

OUCH!

[codedog]

WE also have one for BLUE Cross, no carve out,-WHAT a joke

SO Medicaid I will bill Just BILL CPT code 21390,
Blue cross I WILL bill 21390 with L8610(wHICH they probably wont pay ),What A LOSS