Wiki FEMTO

[mariawilliams]

is there a trick to getting femto paid by any insurance? we consider it as an upgrade and patient signs a form for payment responsibility and do not bill it to insurance. We keep getting irate patients calling in stating that their insurance companies state that they will pay it if we give them a cpt. I was under the impression that no insurance pays it because either there isnt a cpt, or its deemed as not medically necessary. But then i thought i read somewhere that a category III code can be used although its at insurance discretion if it wants to pay or not?

 

[thomas7331]

is there a trick to getting femto paid by any insurance? we consider it as an upgrade and patient signs a form for payment responsibility and do not bill it to insurance. We keep getting irate patients calling in stating that their insurance companies state that they will pay it if we give them a cpt. I was under the impression that no insurance pays it because either there isnt a cpt, or its deemed as not medically necessary. But then i thought i read somewhere that a category III code can be used although its at insurance discretion if it wants to pay or not?

Can you describe what specific procedure you're referring to here? By my understanding, Femto is a type of laser that could be used in a number of different procedures, and without knowing which you're speaking about, it's impossible to recommend codes.

 

[mariawilliams]

Femto performed with 66984

 

[SharonCollachi]

Read this article and see if it answers your questions: https://www.reviewofophthalmology.com/article/femto-reimbursement

 

[nalld@health.missouri.edu]

In my experience FEMTO is not paid by insurance. Its considered an upgrade and patients sign a self pay agreement and pay ahead.

 

[Cheezum51]

Someone isn't explaining the use of FEMTO properly to your patients. Not a covered service so have your Medicare pts sign an ABN before the surgery and self pay agreement and collect those fees up front.

Tom Cheezum, OD, CPC, COPC