Hello ASC coders ,
I think the ASC where I work at may have to eat this cost. First let me say this is a MEDICAID insurance.
Doc did A procedure of OPEN REDUCTION of RIGHT ORBITAL fRACTURE with ALLOPLASTIC IMPLANT . cpt code 21390 is the code. Now it states in THE CPT code book
WITH IMPLANT . So I code it as 21390 rt with dx code 802.6.
They also have an invoice attached to it stating how much for the implant -$1949.00
Again this is a MEDICAID ONLY
IS there A certain implant code I can use also. Idont think i can, maybe I am over looking something. I know Medicare ONLY PAYS 1721.88 ON THIS procedure , and correct me if I'am AM wrong, I dont see MEDICAID paying close to this amount.
ANY suggestions please .
and wHAT IF WAS blue cross -?
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