Have a new pain doc on board who says he used to bill approximately $300 for an epidural kit and get reiumbursed around $130. I've told him since these kits can be customized that there wouldn't be a specific HCPCS to even code it. I also told him that because he does epidurals as outpatient in an office setting that the kit would be bundled with the procedure. He insists there is a way to be reimbursed. Any help would be greatly appreciated! TIA...B
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Wiki Epidural kit?
- Thread starter beckycmbs
- Start date
Michele Hannon
Guest
Medicare does not reimburse separately for supplies used to perform procedures in the office; this includes pain management procedures. Medicare considers supplies to be bundled into the fee for the service rendered.
Other third party payers may reimburse for supplies typically by using CPT 99070. Some payers will reimburse for the epidural tray as supplies with the HCPCS code A4550. At contract negotiations it should be clarified what supplies are reimbursed separately and how to bill for them: line itemized with the contents of the tray or one line item 99070/A4550.
Other third party payers may reimburse for supplies typically by using CPT 99070. Some payers will reimburse for the epidural tray as supplies with the HCPCS code A4550. At contract negotiations it should be clarified what supplies are reimbursed separately and how to bill for them: line itemized with the contents of the tray or one line item 99070/A4550.
Billing surgical trays In pain management
My physician was told in a conference two weeks ago that they should be billing for A4550 trays. I have been paid in the past by commercials but not medicare. Why are they telling them to bill these if inclusive with the office proedure? Please help
My physician was told in a conference two weeks ago that they should be billing for A4550 trays. I have been paid in the past by commercials but not medicare. Why are they telling them to bill these if inclusive with the office proedure? Please help
Melissa Harris CPC
Expert
Some insurances pay for the trays, mostly commercial. Sometimes people are not educated on the reimbursement policies of insurance carriers.
Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management