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Surgical Supplies, Bundled?

  1. #1
    Default Surgical Supplies, Bundled?
    Medical Coding Books
    How do I know if the surgical supplies are bundled to the procedure?

  2. Default
    HAy algunos materiale que se consideran bunddle Pero mi experiencia en radiologia
    para el 2009, fue positiva, hubo denegaciones pero someti apelaciones y recibi el pago
    por el servicio. Entiendo que en ocasiones tienes una feedback positivo en otras ocasiones no.
    Hay que leer mucho y entender la politica de pago de cada plan medico

  3. Default
    My response is NO,
    You have to see the policy payment of each insurance.

  4. #4
    Columbia, MO
    the way I was taught which is not always absolute but I have found is a good rule of thumb. If the surgery/procedure could not be performed without it then it is inclusive.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    These are the guidelines we have used for medical supplies. Hope it helps:

    Reimbursement Policy
    Consumable Medical Supplies should be billed using the applicable HCPCS code(s).
    Casting & Splint Supplies (Q4001-Q4051) are payable in addition to other services billed on the claim.
    Durable Medical Equipment: Consumable medical supplies provided in conjunction with DME are covered if the supplies are necessary for the function of the equipment and the equipment is covered under the plan.
    Diabetic Supplies
    Claims for insulin needles and syringes (A4206, A4207, A4208, A4209, A4215) will be paid under the member's benefit plan, either medical or pharmacy.
    Claims for lancets (A4258 and A4259) will be denied as consumable supplies, unless covered under state mandate or pharmacy rider.
    Claims for glucose test strips (A4772, A4253) will be denied as consumable supplies, unless covered under state mandate or pharmacy rider.
    Claims for glucometer devices (E0607, E0609) will be paid under the DME benefit.
    Surgical Trays: Surgical trays are considered reimbursable for select procedures.
    Oxygen and Oxygen Delivery Systems/Supplies: Oxygen and Oxygen Delivery Systems/Supplies are not considered consumable supplies or DME. They are considered under a member's medical benefit.
    Breast Reconstruction and Prostheses: Breast prostheses are covered under the EPA benefit. Mastectomy bras are covered following a mastectomy under a member's medical benefit.

  6. #6
    Default thanks
    Thanks to all. I certainly could use all those info.

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