Ob-Gyn Coding Alert

Question: Can I use A4550 (surgical trays) with 57454 (colposcopy [vaginoscopy]; with biopsy[s] of the cervix and/or endocervical curettage)? Medicare does not allow this charge, and most insurers also deny it as inclusive, but I have received reimbursement from others.

Connecticut Subscriber

Answer: As you point out, the insurer will determine whether a surgical tray is included or excluded from a surgical procedure so it will be a trial-and-error method unless you have a written payer policy on the topic. The acceptance of A4550 is not universal by private payers either, as this code was developed by HCFA for the Medicare program. Some payers will instead only recognize 99070 (supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]).