Wiki TAVR, MICRA, WATCHMAN

Griffith_Tiffany

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Hello,
Has anyone had any issues with getting these 3 procedures paid with Medicare Noridian? I have seen an Issue with Medicare Noridian denying for incomplete information being on the claim.
this is how the claims have been billed
Watchman
33340-Q0
place of service is 21
dx mainly used is I48.0 primary, Z00.6 secondary
NCT 02699957 in box 23 on the 1500 form
MICRA
33274-Q0
I49.5 prime, Z00.6 Secondary
Place of service 21 or 22
NCT 03039712 in box 23 of the 1500 form
TAVR
33362-62, Q0
I35.0 prime, Z00.6 secondary
Place of service 21
NCT 03635424 in box 19 and 23 of the 1500 form

Does anyone see anything that sticks out to them of what is missing or incorrect? all the information I have is from MLN matters and have been billing from those guidelines.
Thank you in advance for your insights
 
We add the size and type in the free text box for TAVR (ex: "29mm Edwards Sapien S3") If you have the Model number I would add that too

I do no bill for the MICRA but I would guess that you can do the same (ex: Micra Model MC1VR01)

We add the NCT number in the free text box for Watchman. So it is in box 23 and in the free text. (I just took over the Watchman coding so I don't understand the rationale behind it but that is how the previous coder did it and it has been paid)
 
Last edited:
We add the size and type in the free text box for TAVR (ex: "29mm Edwards Sapien S3") If you have the Model number I would add that too

I do no bill for the MICRA but I would guess that you can do the same (ex: Micra Model MC1VR01)

We add the NCT number in the free text box for Watchman. So it is in box 23 and in the free text. (I just took over the Watchman coding so I don't understand the rationale behind it but that is how the previous coder did it and it has been paid)
Thank You,
I had not thought of that, hopefully that works :)
 
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