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Wiki 33249,q0 (ide,nct) medicare

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ellis3350

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So our Cardio Group has been having issues getting our 33249 ICD's paid by Medicare when the patient is outpatient and we are using the Q0 Modifier. We've been round and round about when to use a IDE and NCT on the claims. Most of our patients are having the ICD's placed for primary prevention with devices that are already FDA approved. With us being on the professional side of coding, we've tried to mirror what the facility side is billing because they are getting paid on these claims and we aren't, and it still isn't working. If someone has had this problem and has figured out what Medicare is needing on these claims to get them paid, please let me know.

Thank you,

Diana Ellis
 
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