Hello,
Does anyone have any current/definitive resources regarding charging for omnipaque supply (Q9967) for fluoroscopic guidance in the office setting? If not definitive resource, first hand experience with billing this scenario?
In our ortho practice, patients will receive therapeutic injections under fluoro guidance (CPT 77002) in the office. I have received mixed feedback and am looking for help from anyone with current knowledge in this realm. While I understand individual payers may have different reimbursement policies, I want to be sure it is, in fact, chargeable.
I did find a MPFS final rule that indicated low osmolar contrast media (LOCM) (which is what omnipaque is) and high osmolar contrast media (HOCM) were removed from the PE database as they have separate, recognized HCPCS codes but it is from 2006. However, I still have folks saying that the contrast is bundled. While I agree that, based on the CPT descriptor of 77002, the injection of the contrast is bundled, I don't believe the supply is and I'm trying to prove it definitively. Again, specifically in the office setting. Separate research confirms it is separately reported (although bundled) per OPPS for facilities.
Final rule: https://www.govinfo.gov/content/pkg/FR-2006-12-01/pdf/06-9086.pdf
(iv) Low Osmolar Contrast Media (LOCM) and High Osmolar Contrast Media (HOCM)
Because separate payment is available for both types of contrast media, we proposed to delete LOCM and HOCM from the PE database in this final rule with comment period (70 FR 70138).
Comment: Several specialty organizations expressed their appreciation for implementing the recommendations for the PE changes in section (i) of this section to CPT codes 36522, 78350, 76975 and 15852; in section (ii) of this section for changing the amount and test substance inputs in CPT 95015; in section (iii) of this section for implementing the PE changes to the flow cytometry CPT codes 88184 and 88185; and in section (iv) of this section for removing the LOCM and HOCM from the PE database because they are separately reimbursed. Response: We will implement these changes for CY 2007.
Thank you in advance!
Best regards,
Jessica
Does anyone have any current/definitive resources regarding charging for omnipaque supply (Q9967) for fluoroscopic guidance in the office setting? If not definitive resource, first hand experience with billing this scenario?
In our ortho practice, patients will receive therapeutic injections under fluoro guidance (CPT 77002) in the office. I have received mixed feedback and am looking for help from anyone with current knowledge in this realm. While I understand individual payers may have different reimbursement policies, I want to be sure it is, in fact, chargeable.
I did find a MPFS final rule that indicated low osmolar contrast media (LOCM) (which is what omnipaque is) and high osmolar contrast media (HOCM) were removed from the PE database as they have separate, recognized HCPCS codes but it is from 2006. However, I still have folks saying that the contrast is bundled. While I agree that, based on the CPT descriptor of 77002, the injection of the contrast is bundled, I don't believe the supply is and I'm trying to prove it definitively. Again, specifically in the office setting. Separate research confirms it is separately reported (although bundled) per OPPS for facilities.
Final rule: https://www.govinfo.gov/content/pkg/FR-2006-12-01/pdf/06-9086.pdf
(iv) Low Osmolar Contrast Media (LOCM) and High Osmolar Contrast Media (HOCM)
Because separate payment is available for both types of contrast media, we proposed to delete LOCM and HOCM from the PE database in this final rule with comment period (70 FR 70138).
Comment: Several specialty organizations expressed their appreciation for implementing the recommendations for the PE changes in section (i) of this section to CPT codes 36522, 78350, 76975 and 15852; in section (ii) of this section for changing the amount and test substance inputs in CPT 95015; in section (iii) of this section for implementing the PE changes to the flow cytometry CPT codes 88184 and 88185; and in section (iv) of this section for removing the LOCM and HOCM from the PE database because they are separately reimbursed. Response: We will implement these changes for CY 2007.
Thank you in advance!
Best regards,
Jessica
