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Implant billing

  1. #11
    Salt Lake City
    Default implant billing
    Medical Coding Books
    I've had good success billing for screws with a C1713, mesh with a C1781, etc.... There are some payers that only will take the 99070 though. I allways send a copy of the invoice along with the bill to show what it was and how much it cost. You might want to try that.
    codermcdreamy CPC, CPC-H

  2. Unhappy

    Medicare does not pay for implants in the ASC with the exception of very few codes. The hardware that you are referring to is the pass through code C1713. This code is payable in the hospital setting only.

    While I agree with your manager they are implants. Medicare at this time considers them part of the service performed and included in your reimbursement. I was hopping that with the coming of APC's in the ASC world we would get implants. Only to find out, this is still just a dream. Even with the new payment method coming, Medicare still will not pay for hardware implants such as k-wires, plates, screws, nails, or anchors.

    This was discuss on the grassroots national forum with Medicare back in September when they had open floor discussion about the APC payments.

  3. #13
    Midwest Oklahoma City
    Default Kwire
    Is there another code besides L8699 for a Kwire. I have researched and unable to find one. but someone insist that is not a coder telling us that there is a code.


  4. #14
    Quote Originally Posted by kphilp05 View Post
    Is there another code besides L8699 for a Kwire. I have researched and unable to find one. but someone insist that is not a coder telling us that there is a code.

    no there is not another code for K-wires, L8699 is what mst use unless your contract requires you to use 99070 which I have seen before.

    This thread is wayyyyyyyyy outdated now from 2007 so information previously posted prior to your inquiry may be outdated as well
    Mary, CPC, CANPC, COSC

  5. Default Implant Billing.
    As an ASC we bill plates/screws/guidewire under the L8699 HCPCS code and with almost all payers we supply an implant log/invoice and the operative notes. Recently it has been brought to our attention that drill bits/k-wires and the like cannot be billed because they aren't actually "implants". Although these items are not actually left in the body they are included in the implant trays that our vendors supply. We thought it made sense to bill these items because they are a part of the implant sets. Does anyone have any thoughts on this? We can't get a clear answer.

    Also, can implant in/outs (waste) be billed? I have heard that as long as the implant touched the patient it can be billed.

    Any thoughts would be much appreciated.

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