Wiki Sling Procedure

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smcbroom

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I have a question for someone...we performed a sling procedure on a Medicare patient and billed with 57288 but also was trying to get paid for the implant itself by using L8699. I know the L8699 has a status indicator of N1 but was wondering if anyone else had experience billing Medicare with these procedures and got paid for the implant? I work for an ASC. Any suggestions would be helpful. I have a feeling we are going to have to "eat" the amount paid out for it and I'm not sure why we scheduled it here. HELP!!
 
HI I will check with my friend who codes for ASC and my surgeon does slings all the time there. Since I don't code for the supplies I can't tell you that. I will check with her Friday.
Tammy H, CPC
 
As of 1/1/08 Medicare reimbursement for 57288 includes payment for the sling
implant. Therefore the L8699 is no longer paid separately for the ASC. You
have to decide based on the cost of the sling and the local Medicare fee
schedule if you can justify doing the case. In our location the sling
reimbursement is about $1100, the sling cost is about $800. Hope this helps, this came from fellow codes Mary Whitmore, cpc.
 
I agree with Tammy, unfortunately Medicare will not reimburse for these.

On a side note, for other commercial carriers, I usually use C1771 rather than L8699.
 
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