Results 1 to 2 of 2

Novasure Ablation Reimbursement

  1. #1
    Location
    Columbus, Ohio
    Posts
    89
    Smile Novasure Ablation Reimbursement
    Exam Training Packages
    Does anyone know how to get the maximum reimbursment for a Novasure Ablation. I code 58353 for Endometrial ablation w/o hysteroscopy & I use 58563 for endometrial ablation w/ hysteroscopy. The ablation w/ the hysteroscopy is the one that is more expensive and we are only getting reimbursed $300-$400. That's not even half of what we bill for the procedure! Please help!

    Karey,CPC

  2. #2
    Location
    Kansas City, MO
    Posts
    751
    Default
    First are these being done in office or at a facility? Normally, facility reimbursement is lower because you don't have the same overhead that you do in the office. As an example, I have provided our Medicare reimbursement for these codes below. As you can see, the reimbursement for the procedure in a facility (Hospital, Surgicenter) is less then the non-facility (Office). So you need to consider where you are doing the procedure and check to see if your place of service code it correct on your claims.

    Non-Facility 58353 $1024.82
    Facility 58353 $209.89

    Non-Facility 58563 $1669.68
    Facility 58563 $332.61

    You also need to take a look at the fee schedules for all of your insurance contracts and see if they include facility and non-facility reimbursement as well.

    Angela Jordan, CPC
    Manager Coding & Compliance
    Women's Healthcare Network, LLC

Similar Threads

  1. Replies: 1
    Last Post: 05-09-2014, 01:11 PM
  2. Replies: 2
    Last Post: 08-17-2012, 07:50 AM
  3. Novasure help!
    By NKenner in forum OB/GYN
    Replies: 2
    Last Post: 04-13-2012, 09:47 AM
  4. Novasure help!
    By NKenner in forum Outpatient Facilities
    Replies: 1
    Last Post: 04-12-2012, 10:44 AM
  5. Wiki Diagnostic hysteroscopy w/D&C and Novasure Ablation
    By kbarron in forum OB/GYN
    Replies: 9
    Last Post: 02-05-2009, 05:01 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.