Wiki implants in ASC setting

[pochranek]

We are trying to get our implants paid by CMS and are currently using C1713 which is not a recognized code by CMS for ASC setting. My question is - would L8699 or A4649 be appropriate HCPCs codes for implants?

 

[wannabecoder]

L8699 is usually for us considered unlisted so you'd have to submit the invoice etc and appeal. The A4649 is usually a general supply code and is part of the global ASC package. You might want to check your contract with the payor and/or fup with the provider relations rep on this to see if you get seperate reimbursement for the implants? Many times if you dont, its considered part of the bundled package for the ASC and you take the write off unless you somehow have an ABN, but again if your an inplan provider with a commercial payor you may not be able to do an ABN. Hope that helps!

 

[pochranek]

Dear Wanna -

thanks so much for your input - it really helps!