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Essure procedures

  1. #1
    Default Essure procedures
    Medical Coding Books
    Is anyone doing Essure procedures in their ASC facilities? If you are, what codes are you using and how is the reimbursement?

  2. Arrow Essure
    I am doing this procedure on daily basis. Take 58565 for Essure Procedure; L8699 for the implant. V61.5 and v25.2 can be the compatabile Dx and Volume 3 should be 66.29. Anesthesia should be 00952

    Thank You
    Amit Joshi MSc,CPC,CPC-H

  3. #3
    Default
    Thank you for your response. Are any of the carriers paying for the L8699 for the implant?

  4. Arrow
    L8699 is the correct code for implant. I am intentionally using it and never had face a denial on this.

    Thank You
    Amit Joshi MSc,CPC,CPC-H

  5. Default
    How would I code for the essure procedure 58565 if the physician is billing the global which he is supplying the essure device, I know I would use v25.2
    but what procedure code would I use to be paid for the facility in the ASC setting?

  6. #6
    Default
    Hi,

    Just heads up on the Essure we do a lot of them and CIGNA pays the same
    for this procedure no matter where it is done. They pay around 400 or so
    which no where near covers the device itself. I am currently trying to find
    a way to appeal. It is best to always check the payment schedules for each
    different insurance company since Blue Cross and several others are doing
    quite well on payment.

    If anyone has any suggestions on how to get CIGNA to at least cover the
    device I would appreciate it.

    thanks
    Pam

  7. Question Shirley
    I am reaching out to anyone out there that can help with this scenario on how to bill for an Essure Insertion that was done in the office where it took using 3 coils, We got 1 side in but tried the other side that did not work, tried another coil and it did not either, so she only have one side done, and we use 3 coils, if any one has any info that will assist me please reply. Thanks
    Last edited by mymorris; 06-14-2017 at 09:20 AM. Reason: wrong information

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