Podiatry Implant

[amandamcagle@gmail.com]

We have a podiatrist who performs procedures in which a specific implant is typically utilized. However, in this case, both the physician and the patient have agreed to use an alternative implant that carries a higher cost. The patient is willing to pay the difference in cost, but we are uncertain whether an Advance Beneficiary Notice would be required for the additional amount, or whether it is permissible for the patient to elect a higher-cost implant under these circumstances in general.

And how would that be represented on the claim? This scenario is similar to the Cochlear implant guidelines, but I haven’t been able to find anything specific to any other implantable.

Any assistance or direction you can provide would be greatly appreciated.