Wiki Payer question on Bridge to Transfer- Artificial Heart

Cpatten

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Port St John, FL
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Has anyone run into issues when reviewing a bridge to transfer artificial heart known as SynCardia? The correct ICD10-PCS codes for the facility appear to be 02RK0JZ and 02RL0JZ, however, these codes edit on Medicare Code Edits 11 and 17, unless billed as a clinical trial. Has anyone in the payer field overturned the Medicare Code Edits? Has anyone in the billing world found a way to bill that did not deny, without billing clinical trial DX Z00.6? How are other payers handling this scenario, when the member was not part of a clinical trial?
Thank you.
 
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