Wiki Coding/Billing for implants HCPCS

[JDuhaime]

Recently took over billing for implants for ASC Ortho. They were submitting all implants under L8699 and a lot are getting denied.

Should they be submitted with more specific C codes per each supply instead of the L8699? Ex: Guidewire is C1769

 

[dnostdahl]

Look at the implant vendors website sometimes they have Billing & Reimbursement Guidelines, or suggestions. Sometimes it depends on the implant & whether it is inclusive to the procedure code billed. Example a Spinal Cord Stimulator & corresponding HCPCS would be: L8680 HCPCS Code but some payers bundle it in with the procedure. At least checking on the vendors website it will give you a bit of guidance. Hope this helps.