nsteinhauser
Expert
If anyone out there has any information about this, I would greatly appreciate it.
If you are negotiating a contract with a payer and you want to 'carve out' separate payment for Strattice* (a bioengineered skin substitute), what code would you use?
Lifecell - the company that makes Strattice* - says to use "Q4100 - skin substitute, not otherwise specified" - because there is not a unique HCPCS code for Strattice like there is for Alloderm*, etc.
However, when you look up "Q4100," the ASC Payment Indicator for that particular code is "N1" (versus "K2" - what a lot of the skin substitutes are.) "N1" reads 'packaged service/item; no separate payment made.' These items/services are supposed to be packaged into APC rates.
So does that mean as an ASC, we shouldn't be using that HCPCS code separately? Even in a separate payment situation in a contract?
I'd appreciate any thoughts.
If you are negotiating a contract with a payer and you want to 'carve out' separate payment for Strattice* (a bioengineered skin substitute), what code would you use?
Lifecell - the company that makes Strattice* - says to use "Q4100 - skin substitute, not otherwise specified" - because there is not a unique HCPCS code for Strattice like there is for Alloderm*, etc.
However, when you look up "Q4100," the ASC Payment Indicator for that particular code is "N1" (versus "K2" - what a lot of the skin substitutes are.) "N1" reads 'packaged service/item; no separate payment made.' These items/services are supposed to be packaged into APC rates.
So does that mean as an ASC, we shouldn't be using that HCPCS code separately? Even in a separate payment situation in a contract?
I'd appreciate any thoughts.