ASC Implants

SRENALDE

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Loma Linda, CA
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Questions: When coding for CPT (ex:23515) the code includes internal fixation, can we still bill for hardware, plates, etc?

Are there different CPT books that apply to Ambulatory Coding? I'm asking because some of the hardware costs more than the reimbursement of the procedure. The surgeons are concerned and I want to get my fact straight.

Thank you!
 

Tntmom

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I've been wondering the same thing. Great question!

I've understood the CPT book to be universal and all the codes are for ASC as well as physicians.
 

mswalker

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It would depend on your individual contracts with insurance companies as to what can or can not be billed. Our ASC's has contracts that specifically state that implants are separately payable at cost/cost + 10% /etc.
 
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