Wiki 0191T and 0376T iStent inject

[Stenglein]

Has anyone run into the iStent inject (placement of 2 istents) and the medicaid insurance indicates the 0376T is not on the fee schedule, so not payable. The LCD for this indicates it is payable for our locality, but with the type of insurance, I am not sure a letter of medical necessity would work. Any ideas?

 

[saddie2k]

Hi!
The iStent inject is not covered. We enter the 2nd code as a zero charge if used.

 

[Stenglein]

Hi!
The iStent inject is not covered. We enter the 2nd code as a zero charge if used.

In the ASC we do enter the second as a no charge, However, with the professional charges (we have both the ASC and the professional pieces) we enter both charges.

 

[MSCALLIE79]

iStent inject is not covered by Medicaid in North Carolina