Wiki Loop recorder implant then explant??

[cvand1972]

Have any of you run in to this?
Patient had Loop recorder implanted on 11/25/09. Then, they decide to remove it on 2/5/10. Our local Medicare is denying the explant for being inclusive in the implant procedure. Trying to figure out what modifier we can use, if any.

 

[cvand1972]

I'm thinking 78.
The MD decided she wasn't having any syncopal episodes so decided to remove it. I guess that could be 'unplanned', right?

 

[deeva456]

I agree with you, try using modifier 78. I'm surprised the removal was denied, Medicare usually will pay.

Dolores, CPC-CCC