s2900

airart

Guru
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UT Dallas, TX Chapter
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S2900

The reason for no replies must be because not many are using this due to its not a covered service.

Medicare manual says that this is not payable by Medicare. Here are what some other payers say on the S2900.

HCPCS S2900 (robotic-assisted surgery) – Emblem Health

Submit HCPCS S2900 with the base procedure. In their claims, surgeons should include HCPCS code S2900* in addition to the main surgical procedure code when they have performed a surgical technique that requires the use of a robotic surgical system.
S2900 is not reimbursable.

According to Emblem Health's reimbursement policy, the types of instruments, techniques or approaches used are left to the discretion of the surgeon. As such, code S2900 is not separately payable and the physician will not be additionally reimbursed for this code.

What is robotic-assisted surgery?

Robotic-assisted surgery refers to an emerging technology used to assist the surgeon in controlling the surgical technique. The surgeon generally views the operative field through a terminal and manipulates robotic surgical instruments via a control panel. Views of the surgical site are transmitted from tiny cameras inserted into the body. The use of computers and robotics is intended to enhance dexterity in order to facilitate micro scale operations.

*HCPCS Code S2900: Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)

BCBS of MS (Mississippi)

POLICY ( :eek: This was back in 2005 and its the only policy I have seen so far that covers robotic assistance)
Robotically Assisted Laparoscopic Radical Prostatectomy is considered medically necessary. (revised 7-21-2005)

POLICY GUIDELINES
Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.

SOURCE(S)
http://www.fda.gov/cdrh/pdf2/k021036.pdf

Articles:
http://news.aapc.com/index.php/2009/10/robotic-surgery-standard-coding-describes-high-tech-approach/
 

karey

Networker
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89
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Columbus, Ohio
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I am in Ohio and I have never heard of this code or had any problems since I have started coding 5 years ago. With that being said, I have recently received a denial from Molina Healthcare of Ohio stating that the laparoscopic surgery performed (58662) needs S2900 added to the claim in order for it to be paid. I KNOW that I have coded many laparoscopic procedures for MANY Medicaid recipients and I have never listed this code and have not had any problems with reimbursement.

Can someone give me some insight on why they may be "all of a sudden" stating this needs to be listed? :eek:
 

kristamontes

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It seems that the robotic surgeries are only being accepted by some carriers due to it being an "experimental" process. I needs to be approved as necessary before more carriers cover it. CMS does not consider it payable but outside of trial and error, I'm not sure how to find out who pays it and who doesn't.
 
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