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Thread: Billing for devices with facility

  1. #1
    Join Date
    Apr 2007
    Atlanta Perimeter

    Default Billing for devices with facility

    AAPC: Back to School
    I work in Billng for an ASC that does Gynecology only. We've been open for 5 years and have always billed for the facility using revenue code 490. Recently we were told by Cigna that we can bill for our devices in addition to our procedures and receive reimbursement for both. This does not sound right to me. Wouldn't they have to reduce our normal reimbursement at least a little to make it worth it for them to pay us as they have been paying us already and then pay us separately for a device?

    Also, I have only billed for the facility code only with rev 490 so can someone offer feedback on how the device billing is supposed to be presented on the UB-04?

    I can't find HCPCS codes for our devices that my company is wanting to bill separately for so I think they are under the impression that we can just bill CPT codes as usual with the Revenue code 278 to indicate devices. I do not believe this is the way the claim should be presented, but I am aware that I could be wrong since I've never done device billing before.

    I guess the big question is : to bill with Rev code 278, we have to use HCPCS codes not CPT codes, right?
    Last edited by rmdavidson3@yahoo.com; 12-16-2010 at 07:52 AM.

  2. #2
    Join Date
    Apr 2007
    Monmouth, NJ & Dover, DE


    At my facility we bill out rev code 270 with HCPCS A4649 for medical supplies [such as the Novasure device] and rev code 278 with HCPCS L8966 for implants [such as Adiana birth control]. We are contracted with some of our carriers and it is written into the contract with these HCPCS codes. We also bill out these same codes to our non contracted providers. This does not drop the reimbursment for the main procedure code. Hope this helps you.

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