• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Any insurance pay for robotic surgery? 20985

O

Orthocoderpgu

True Blue
Messages
2,128
Location
Salt Lake City, UT
We have a new provider who does joint replacements and uses robots to help with surgery. Does any insurance pay for code 20985 separately or do they bundle this? Any advice from what you have seen would be helpful. Thanks.
 
Jeanne CPC

Many Insurance do not pay for the navigation however we receive payment from the following insurance companies for CPT code 20985,
Anthem
Anthem BCBS of CA
Anthem BCBS of CT
Anthem BCBS of GA
BCBS of Blue Choice of New England
Blue Benefit of MA
Cigna
Coventry Health
Medicare
UHC State(RI)
UHC
UHC Rhody/ RiteCare (Medicaid)
Workers Compensation (RI)
It depends on the medical policy of the insurance and their fee schedule will determine the allowable. Good Luck!
 
Orthocoderpgu said:
We have a new provider who does joint replacements and uses robots to help with surgery. Does any insurance pay for code 20985 separately or do they bundle this? Any advice from what you have seen would be helpful. Thanks.
Click to expand...

I'm a little late to the dance here....lol.....but code 20985 is for computer assisted coding, not robotic assistance. Per the AMA and a Knowledge Base Inquiry I did several years ago, even though you use a computer to control the robot, they see this as robotic assistance and not computer assistance. At that time they had no intention of creating a claim for robotic assistance.

Feel free to email me if you have further questions. I worked as a consultant and one of my clients had robotic assistance.
 
Robotic is S2900

I agree with that for robotic assistance the correct code is S2900. And that carriers generally don't pay for it. We were able to get 1 carrier to put it into our contract to pay for that code.
 
Email?

mmorningstarcpc said:
I'm a little late to the dance here....lol.....but code 20985 is for computer assisted coding, not robotic assistance. Per the AMA and a Knowledge Base Inquiry I did several years ago, even though you use a computer to control the robot, they see this as robotic assistance and not computer assistance. At that time they had no intention of creating a claim for robotic assistance.

Feel free to email me if you have further questions. I worked as a consultant and one of my clients had robotic assistance.
Click to expand...

Hi,

I would love to talk with you about this subject, can you email me at pamela.guada@yahoo.com

Thank you,
Pamela
 
You must log in or register to reply here.
Top