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Wiki Does anyone know if it is a requirement to bill pass through codes to Medicare?

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dmakepeace

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Our MAC has info about pass through devices for ASC (attached file) but we are running into issues with billing it. The patient secondaries don't recognize the code (not in their fee schedule) so the patient ends up owing a huge amount of money. I know there is a benefit for showing our costs for these newer technologies so when an actual CPT code is created the allowed amount is comparable, but we don't want to bill it if it creates monetary stresses on our patients.
 

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Pass-through is CMS standard requirement and therefore should be reported. You might check if procedure/s (not drugs biologics) is/are device-dependent or not. If not then only you should remove the pass-through device (C hcpcs) else you should report that. You can cross check this way too as sometimes scrubber put the pass-through in a revenue code line which don't require a hcpc either. So in that case it can be removed.

Good day!

Thanks,
Maan
(Medicare specialist, CMS MACs)
 
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