Knee technology might not compute with carriers
Published on Mon Nov 02, 2009
High-tech navigation system doesn't always mean payment. Some orthopedic surgeons use a computer navigation system during total knee replacement surgery, which you'll report with +20985 (Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less [List separately in addition to code for primary procedure]), says coder Carol Wilson. Some payers might deny reimbursement on the grounds that you're reporting an experimental procedure, but there's hope with other carriers. Medicare, for example, will reimburse for +20985. CPT 2009 retired companion codes 20986 and 20987 in favor of reinstated Category III codes: • +0054T -- Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images(List separately in addition to code for primary procedure) • +0055T -- Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure). Most coders find that getting reimbursed for Category III codes is a challenge. Be prepared to submit [...]
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