Palmetto GBA: Thermal Capsulorrhaphy Non-covered
- By admin aapc
- In Billing
- April 15, 2011
- 1 Comment
Palmetto GBA has determined thermal capsulorrhaphy not medically necessary due to the lack of clinical evidence to demonstrate improved health outcomes. The Medicare administrative contractor (MAC) announced April 7 that claims submitted for this service will be denied.
Also known as thermal coagulation of joints, radiofrequency thermal shrinkage, electrothermal assisted capsulorrhaphy (ETAC) and laser-assisted capsular shrinkage (LACS), thermal capsulorrhaphy is proposed as a minimally invasive arthroscopic procedure to tighten the capsule and ligaments of joints for the treatment of joint instability, including the shoulder, knee, and elbow.
To report this non-covered service, submit CPT® code 29999 Unlisted procedure, arthroscopy.
Palmetto GBA is the Part B MAC for jurisdiction 1 (Northern California, Southern California, Nevada, Hawaii, and the Pacific Islands) and jurisdiction 11 (North Carolina, South Carolina, Virginia, and West Virginia).
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