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Restylane for vocal cord paralysis

C

cgratz

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keyport, NJ
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?
 
cgratz said:
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?
Click to expand...

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.
 
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?
 
cgratz said:
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?
Click to expand...

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
 
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