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Tip: Understand implants, devices related to spinal neurostimulator procedures

Ambulatory Surgery Reimbursement Update, June 10, 2008

Under the new Medicare payment system that became effective January 1, when an ASC facility bills Medicare for spinal neurostimulator procedures, Medicare considers the procedure to be a “device-intensive procedure”—meaning the payment for the implants and/or devices used in these procedures is included in the payment for the procedure.

Because Medicare includes the payment for the implants and/or devices in the payment for these procedures, you should bill the appropriate codes for the procedures performed, but do not bill separately for any implants or devices a physician may have used.

Check with individual payers other than Medicare for their billing policies. Some payers may allow you to bill for the implants or devices separately if they do not consider them bundled into the CPT codes for the procedures.

This tip is brought to you by Ellis Medical Consulting, Inc.

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