Katz Extractor Code?

SharonCollachi

True Blue
Messages
646
Location
Clovis, CA
Best answers
3
It's a foreign-body removal device for ears, nose, etc. Has a little balloon on the end. Looks like a flexible syringe.

Unfortunately, they're like $400 for a package of 5.
 

b.cobuzzi

Guru
Messages
192
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0
Sharon, I am unsure if you are coding for an office or an OR (ASC or outpatient), so I will provide an answer of where to look/ what to do for both:

Office:
There are no codes for devices used in the office. Performance of a procedure in the office pays more than performance in a facility (medicare fee schedule, as we can never be sure if a non-medicare payer uses the same logic). The extra amount paid is used to cover the cost of the overhead and disposables used in the office. So, for 69200, remove foreign body ear, the facility fee is $48.72 (ASC or OR) and the office fee is $83.37. That almost $40 difference is to cover the cost of performing the procedure in the office. But if you used the Katz extractor, which costs $80, the cost would not be covered by the site of service differential.

ASC/OR
There is a possibility that the company that makes the device has gotten a pass through code (a “C” code) that facilities can bill in addition to the grouper, to cover new devices. The company that makes the extractor would know this and be able to tell you the “C” code and if it is a pass through. After a few years, it gets rolled into the APC or grouper and will not be a pass through, therefore not be able to be separately billable in addition to the grouper or APC.

Just to let you know, there are office procedures where the site of service does pay for the cost of supplying what is needed to do the procedure in the office and make revenue for the practice. For example when a provider performs a laryngoplasty with a flexible laryngoscope (which puts gel on one side of the vocal cords to medialize the cords), is coded 31574, Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral. When performed in the OR, it pays $152.30 to the provider and the facility supplies the gel which costs about $800. When performed in the office, it pays $1,029.64 and the provider has to supply the $800 gel. This means the provider is netting $229.64 when performed in the office.

Unfortunately, the site of service differential is not enough for an ear FB extraction to pay for the device.
 
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