hcpcs code for laser replacement tip used with 52648

ncantello

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Does anyone coding for ASC bill for the replacement tip used during procedure 52648, laser vaporization of prostate? It is my understanding that the tip costs around $800 and a new one is used with each patient. I'm wondering if it is possible to bill for this along with 52648. Thanks!
 

mbort

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Since this is a "supply" I do not believe that you can capture anything additional unless you have contracts that reimburse for supplies separately from your facility fee. The RVU's set for this procedure are quite high so your reimbursement "should" already have that factored in. If not, then when its time to renegotiate your contracts, you may want to seek a case carve out for this procedure.
 

ncantello

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The reimbursement is high, but the costs are too. I believe that in addition to the super expensive laser supply, there is an expensive technician fee as well. I'm pretty new to this, what is a "case carve"?

I really appreciate your input. Thank you!
 

mbort

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Case Carve Out is when negotiating a contract, you ask the carrier for additional reimbursement for specific procedure codes.

IE: We have carve outs for ACL reconstructions because the cost to do those procedures is typically higher than the norm.

Hope this helps
Mary
 
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