• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

Restylane for vocal cord paralysis

cgratz

Guest
Messages
7
Best answers
0
Can anyone help with the correct CPT/HCPCS to use for restylane billing. I need to bill for the material but can't seem to find the correct code or if there is even a code to use. Can anyone help?
 

mhstrauss

True Blue
Messages
1,241
Location
Baton Rouge
Best answers
0
Can anyone help with the correct CPT/HCPCS to use for restylane billing. I need to bill for the material but can't seem to find the correct code or if there is even a code to use. Can anyone help?
I'm not familiar with this, but did a little searching around, and there doesn't seem to be one. Restylane is hyaluronic acid, which, per the HCPCS Table of Drugs, is unspec...J3490. A current Aetna coverage document shows the same thing. :confused:

HTH some.
 

cgratz

Guest
Messages
7
Best answers
0
So do you know if I could bill the pt for the material if it isn't payable by the insurance and bill the insurance for the actual procedure?
 

mhstrauss

True Blue
Messages
1,241
Location
Baton Rouge
Best answers
0
So do you know if I could bill the pt for the material if it isn't payable by the insurance and bill the insurance for the actual procedure?
I don't see why not, provided that you follow the payer guidelines for notifying the patient that it may not be covered (ie. ABN if patient has Medicare). BUT from what I was seeing as I was looking for the HCPCS code, it is considered medically necessary for unilateral vocal cord paralysis (which you didn't specify that your patients have unilateral paralysis, I'm just assuming)...just check your payers' coverage guidelines. Here's an example of one that I found:

http://www.aetna.com/cpb/medical/data/200_299/0253.html
 
Top