Iuliana
New
Does anyone bill for Barostim implantation 0266T? I have a hard time getting paid for this by Medicare, I would really appreciate any insight anyone can give me on this.
Thanks.
Thanks.
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Wiki Billing 0266T
- Thread starter Iuliana
- Start date
Elizabeth83
Contributor
- Messages
- 17
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- 0
Good Morning,
Just curious if you have had any luck with payments. I will be billing this for the first time. The company CVRx has provided us comparable codes to use when billing 0266T: 35301, or 33249, or 64568. I would assume I should try the highest RVU code first 35301.
Just curious if you have had any luck with payments. I will be billing this for the first time. The company CVRx has provided us comparable codes to use when billing 0266T: 35301, or 33249, or 64568. I would assume I should try the highest RVU code first 35301.
OpenClaims
Guest
Can you provide the denial so we can see why this is not being paid?
sjtrew
Contributor
Would like to hear from anyone currently billing for Barostim implantation using 0266T. Interested to know if you are receiving reimbursement, does it require an auth? do you bill any post operative care, especially if the procedure is denied as experimental? I am a physician biller, is anyone willing to provide insight on hospital charge for C1825. Was the denial message ever received for review by Open Claims? Thanks in advance!
sjtrew
Contributor
Hi Luliana
are you still having problems getting reimbursed?
ellis3350
Guru
I'm interested about the coding for the Barostim Neo implant too. I see this doesn't take a 62 modifier but I had a Cardiac surgeon place the implant and had a Vascular surgeon do the Carotid exposure. Only one of them can get the 0266T, so interested in what the vascular surgeon would get??? Thoughts?
kdj21113
New
I am interested in this response as well as there are a number of variables at play I believe. Thus, will take ANY help/suggestions/input.
According to our local MAC, Assistant and Co-Surgeon has a status indicator of O. I spoke with one of the largest implanting facilities in Central Florida (referred to me by the rep) where they claim to do a number of these procedures with successful reimbursement. I have asked them to share claim information with no luck. Also, while its generally outpatient, it does also fall under a Vascular DRG and has a 75% device offset cost. (I think) which used to be higher in FY22 @ 96%. This tells me, CMS highly considers the device predominantly the procedure (in so many words). So if you pay $35K for the device, you would have to mark up your device like 400% to see even a small profit. I honestly believe this should only fall under Vascular only as I do not see a way for two surgeons to be reimbursed successfully. Hoping my fellow AAPC community can talk me off the ledge
.
According to our local MAC, Assistant and Co-Surgeon has a status indicator of O. I spoke with one of the largest implanting facilities in Central Florida (referred to me by the rep) where they claim to do a number of these procedures with successful reimbursement. I have asked them to share claim information with no luck. Also, while its generally outpatient, it does also fall under a Vascular DRG and has a 75% device offset cost. (I think) which used to be higher in FY22 @ 96%. This tells me, CMS highly considers the device predominantly the procedure (in so many words). So if you pay $35K for the device, you would have to mark up your device like 400% to see even a small profit. I honestly believe this should only fall under Vascular only as I do not see a way for two surgeons to be reimbursed successfully. Hoping my fellow AAPC community can talk me off the ledge
.