Wiki Billing for devices

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susansisson

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I have a question about devices used during a procedure. The CPT being used is 59851 along with 59200 for the insertion of the dilation device. The HCPC code for the devices used is A4649 which is basically Surgical supply: Miscellaneous. I am getting push back from providers because sometimes they use up to six devices and they are wondering why we are not billing for those devices. It is my understanding that the cost for those devices are wrapped up into the CPTs 59851 and 59200 and that we would only bill with the A4649 if we did not have those CPTs to bill with. Any thoughts on this would be appreciated! Thank you
 
Per NCCI you can only bill the 59851. Supplies are included in the code. The 59200 has the "Separate procedure" indicator which means its bundled into more comprehensive procedures. Its a required component to perform the 58951. No modifier will bypass this as it's a PTP edit with a 0 indicator. Devices left in patients are really the only things billable such as an IUD, pacemaker, stent etc
 
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Sometimes it helps to give examples of other "devices" you would not bill separately. You wouldn't bill separately for a syringe when doing an injecton. You wouldn't bill for needle and suture material when billing for a repair. You wouldn't bill for a scalpel when performing a surgery. etc.
 
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