Wiki latera C9749

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The C code for Latera can only be used by facility billing, for ASC or OR facility. It is a pass through so they can get paid for the implant in addition to their grouper. A physician cannot bill the C code and get paid for it.

Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
Consulting Editor Otolaryngology Coding Alert
www.CRNHealthcare.com
b.cobuzzi@att.net
 
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Follow up question

b.cobuzzi said:
The C code for Latera can only be used by facility billing, for ASC or OR facility. It is a pass through so they can get paid for the implant in addition to their grouper. A physician cannot bill the C code and get paid for it.

Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
Consulting Editor Otolaryngology Coding Alert
www.CRNHealthcare.com
b.cobuzzi@att.net
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Does that mean I can bill the C9749 alone and get paid? I work in an ASC and we are looking to perform our first one of these. I see a lot of threads saying to use the 30999 but this code is on the ASC not allowable list. I wasnt sure if I could bill the C code as the one and only
 
I believe so, Tdesher. I suggest you contact the reimbursement line for Stryker (now owns Entellus) and they should be able to answer your questions.

Barbara Cobuzzi
 
trose45116 said:
How many code for this and do you code the implant separately?
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I sent an email to the rep in regard to coding/billing this in the ASC setting and this is the information I received:

"If you are billing Facility Fees, you would use C9749 for the procedure and C1889 for the implant—when billing for Medicare patients. There are some random payers that accept the C codes, but we don’t have a list of the payers that do. If you bill the C codes, you may or may not get additional payment for the device. That varies by payer. (The L8699 code is a potential option, but the C1889 code description mentions that it’s for a device-intensive procedure, which is what LATERA is.)"
 
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