• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Breast implants for patients w/Cancer

KristieStokesCPC

KristieStokesCPC

Expert
Messages
297
Location
Millport, AL
Has anyone had any luck in getting Medicare to pay for breast implants after reconstructive surgery with a history of breast cancer? We are billing C8600. This is for an ASC.

Thanks in advance!
 
For an ASC facilities and Hospital Outpatient, breast implants are considered paid for through the fee for the procedure. Most C and L HCPCS codes have a payment indicator of N1 (Packaged service/item; no separate payment made). I recommend taking a read of the Medicare Claims Processing Manual: Chapter 14. That is gear towards ASC facilities and helps explain the payment methodology and N1 payment indicator.
 
Last edited:
You must log in or register to reply here.
Top