Health Information Management

Q&A: Reporting magnetic band implantations to treat GERD

APCs Insider, July 17, 2015

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Q: Our physicians want to start implanting a magnetic band around the distal esophagus to treat gastroesophageal reflux disease (GERD). We can’t find a code to report this procedure. Is there one?

 
A: Yes, we do have a code for reporting this procedure. CMS created HCPCS code C9737 (laparoscopy, surgical, esophageal sphincter augmentation with device [e.g., magnetic band]) in January 2014 for implantation of a magnetic ring for the treatment of GERD. This procedure is associated with the LINX® Reflux Management System. This code was deleted effective July 1, 2015.
 
The AMA published two Category III codes in January 2015 to be effective July 1, 2015, related to this procedure – one for the insertion and one for the removal. The two codes will be recognized and payable under the OPPS and are:
 
  • 0392T, laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (i.e., magnetic band)
  • 0393T, removal of esophageal sphincter augmentation device
 
The codes are assigned status indicators of T (significant procedure subject to multiple procedure discounting) and Q2 (T-packaged codes), respectively. The payment rates are included in the July 2015 update to Addendum B.
 

Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Fort Lauderdale, Florida, answered this question.<

 



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