Wiki Please Help/ Implant Code

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bella2

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Hi,

I'm looking for a little advice on a HCPCS code for a Smart Toe,
our Podiatrist is using these for hammertoe repairs. We had submitted L8699
for the implant but AETNA denied the code. The only HCPCS code I can come up with is L8658.

I would love to hear from others to know if I'm on the right track.

Thanks for all responses,

Bella
 
Do you have a contract with Aetna? what revenue code are they wanting? I would use L8699 but it would depend on the what we are contracted for. :)
 
We had to negotiate a carve-out in our ASC contract with Aetna in order for those L8699's to get reimbursed. L8699 is not on their fee schedule allowables so they will deny. If you're not sure whether you have contracted for these to be paid, contact your Provider Rep at Aetna and have them search your ASC contract. Even if you're NOT contracted specifically for that HCPCS code....send letter of Appeal for the item with copy of invoice, see if that works. Good luck!

Jenna
 
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