Wiki Cpt 0238t

[sharper]

Is anyone having trouble getting Medicare to pay for an iliac artery atherectomy? They tell me it's non-covered, so if that's true what code should I be using?

Thanks for your help,
Susan

 

[theresa.dix@tennova.com]

Is anyone having trouble getting Medicare to pay for an iliac artery atherectomy? They tell me it's non-covered, so if that's true what code should I be using?

Thanks for your help,
Susan

Yes this is what I have found also. It is non covered for Medicare and "other "payers pay at there fee if they allow. But now the cath placement is not bundled into this temporary code like the other new 2011 intervention codes. You are using the correct code for iliac atherectomy.

 

[sharper]

So, what else can we do? For years it was a covered service using 35492 so this seems crazy. What would you bill if your doc did an iliac atherectomy?

 

[theresa.dix@tennova.com]

So, what else can we do? For years it was a covered service using 35492 so this seems crazy. What would you bill if your doc did an iliac atherectomy?

You have to bill the temporary code. I have only billed it once since the new codes came out because it is not a procedure done very often that is why it is a temp code. Usually a stent is placed. You know the rule.You should report the code that adequately describe the procedure or service. Since there is one( a code) we have to report it. You cannot report an unlisted code. Some payors may reimburse for this, its up to them. You could probably find out.