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Implants/Medicare

  1. Question Implants/Medicare
    Medical Coding Books
    Hello,
    My question is about billing Medicare in an ASC for implants not on pass through status, (screws,plates,ect.) Is there a modifier, revenue code or indicator of some kind that they require on the claim to let them know these have been added to the procedure charge for reimbursement? Can anyone help with this please.
    Thanks, C

  2. #2
    Location
    Coeur D'Alene, Idaho
    Posts
    39
    Default
    It's my understanding that Medicare will not pay for implants because they consider them as part of the procedure.

    The ASC association posted a list of separately payable procedures here:
    http://ascassociation.org/ancillary2010.pdf

  3. Default
    Thanks this has been my understanding also, but I am being questioned as to whether I am billing them correctly so I am trying to make sure I haven't missed something along the way. Thanks again.

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