Health Information Management

Q&A: Should we be reimbursed for corneal tissue for transplants?

APCs Insider, January 9, 2015

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Q: Why are we not receiving anything from Medicare to cover the cost of corneal tissue? We perform corneal transplants and get paid for the procedure, but receive nothing additional for the corneal tissue itself.
A: CMS does provide reimbursement for corneal tissue acquisition costs. In order to receive the appropriate reimbursement, you must report HCPCS code V2785 (processing, preserving and transporting corneal tissue) on the claim. This line item should reflect the costs associated with the corneal tissue. Without the code being reported, Medicare has no way to reimburse for this, as it is based on the cost, not assignment to a particular APC.
For more, see the Medicare Claims Processing Manual, Chapter 4, section 200.1
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.

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