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delphinus777

delphinus777

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My {Houston} ASC is wanting me to bill for a new product. Its a Microflow spacer [Relieva Stratus] that expands the patients ethmoid sinus area. It is performed like the balloon sinuplasty but this device stays in the patients sinus area for 14 days [US] up to 28 days[UK]. The reps states some facilities bill it as an implant and some as a supply. Any thoughts or input as to your experience with this? Thanks for your input!! :confused:
 
In an ASC I was always taught that if there was something implanted and left with the patient than you would bill it as an implant. Thats my 2 cents:)
 
In our ASC, we have found that our carriers (commercial) define an implant as any implantable device that is implanted into the patient and remains for at least 30 days or more.

If this is the case, we bill the implant providing that we have implants carved out in our contracts.

We are currently looking at this same supply and are questioning whether or not it is considered an implant with insurance carriers, supply or drug delivery device.

The rep states that many people are billing it with L8699 which is an unlisted implant code, which many of my payers will not pay for unlisted. Let me know what you find out as i am curious.

Caprice Walder, CPC
 
Caprice: I was a bit concerned with calling it an implant, especially with the amount of days it will be placed in the nasal cavity. After looking at a few codes I think I am going to try using C1726...... any thoughts? The description on the item states it is a Microflow spacer [a catheter with precision formed micropore reservoir]. Its the closest description.... and I dont want to use 99070. Ugh...thank goodness its friday!
 
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