Wiki Which Rev code to bill with C1769 (272 or 278)?

[windagray]

I am new to hospital billing (after 20 years of private practice) and we are having a debate as to whether or not C1769 should be documented and billed as a supply or an implant. When researching with the UB Editor is shows it can be billed as either. However, the clinical staff feels it should be charted as an implant. The revenue department's stance is that the guidewire is not left in the body and therefore could be billed with 272 as a supply but our software system wont' allow it to be setup as both. I would love feedback of how other facilities have this setup. Thank you in advance!

 

[thomas7331]

I'm not sure how you could justify classifying a guidewire as an implant. For many payers, the revenue code likely won't make a difference in payment here. But if any of your payer contracts give a carve-out or additional payment for implants, I think that if the payer audited these, they would not allow it. It might be worthwhile to check the language in your facility's contracts and specific payer policies, as there could be additional detailed spelled out as to what items may be billed with this revenue code.

 

[CBLENNIE]

I don't think that C1769 would be considered an implant billable with rev code 0278 based on the long description of the code in Encoder Pro.

A guidewire is a thin, flexible piece of material that is guided into a desired blood vessel or hollow organ. The guidewire may be utilized for access, to maneuver to a specific target location, or to provide a platform for device exchanges, stent insertions, and other procedures. A needle (i.e., single-wall, trocar, Chiba, echo-tip, micro puncture set, vascular sheath) is inserted and the guidewire is advanced to the target location under radiological guidance. Once the guidewire is in place, a catheter or other device can be advanced to the target for diagnostic or therapeutic treatment. Guidewires are available in various compositions, coating, diameters, lengths, stiffness, and tip shape. Guidewires are commonly used in biliary, dialysis, urology, respiratory, coronary, and other vascular procedures.​

It seems like it should be considered a supply with rev code 0272, unless for some reason I'm not aware of that would cause you to leave the guidewire implanted in the patient.

What does everyone else think?

 

[windagray]

I certainly can agree both feedbacks however, why would the UB editor show the implant REV code as an allowable REV code if an implant wouldn't apply; I wonder?