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Simplicity Probe

  1. #1
    Default Simplicity Probe
    Medical Coding Books
    When a physician does RFAs is the simplicity probe included in the services or can the patient be billed for this? Thank You

  2. #2
    How do bill for that probe is there a hcpcs code. If you would bill the hcpcs code or supply revenue code and the insurance company states this is adjustment and you have a contract. Then you would have to take the adjustment. If you determine you would want to do an advanced beneficiary notice, the patient can agree to pay for this prior to procedure. How much does the probe cost? Could you attach the invoice when you are billing unlisted 64999 code for this procedure so that they could fiqure that in the cost of the reimbursement.

  3. #3
    Thank You for your response but the unlisted procedure code 64999 is for a procedure, the simplicity probe is a device and there is no hcpcs that I can find. So if the patient signs an ABN then we can bill?

  4. #4
    I using a Medicare billing concept that the reimbursement for the CPT would include the supplies or device used It is hard to say if you bill under revenue code for supplies that the carrier is not just going to say that the reimbursement is included in the procedure if they are a commercial carrier. I thought since it is going to require a letter and notes that you could request that the reimbursement for the probe be included in the Facility portion of 64999. If you don't do this it is hard to say if under the revenue code alone that their will be separate reimbursment. If you request the probe reimbursement be included in the CPT code payment then you can look at that payment and see if they took that into consideration. The only other option would be to ask to reimburse you under the revenue code. Are you billing for ASC or outpatient hospital.

  5. #5
    ASC, provider wants to bill the patient. Once again Thanks

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