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Outpatient Surgery E-Weekly

Malpractice Verdicts Often Favor Physicians

Physicians come out on the winning end of 80% of malpractice claims that end in jury verdicts, according to researchers at Massachusetts General Hos...

Study: CT Colongraphy Effective in Finding Polyps

A CT-scan-based, laxative-free "virtual colonoscopy" may be as effective as standard colonoscopy in finding potentially cancerous polyps, according ...

Wrong-Site Prevention Video Shows the Right Way

Wrong-site, wrong-patient and wrong-procedure surgery must be prevented at all costs. The 3 steps of the Joint Commission's Universal Protocol make ...

Archive > October, 2003 Vol. IV, No. 10

Coding & Billing

Getting Reimbursed for Orthopedic Implants

Judie English

Judie English Q Our facility uses a lot of implants for surgical fixation and small-joint reconstruction. These devices increase our overhead for some procedures. Can we obtain reimbursement to offset the implant costs in addition to the cost of the surgical procedure?

A Yes, you can bill for high-cost items, such as joint implants, plates, screws and arrows, that fall outside the global surgical package. Medicare requires that you use HCPCS codes for prosthetic devices; however, the approved list for ASC implant reimbursement is minimal (see "Sample Approved Prosthetic Device Codes" below). For Medicare claims, bill the device in conjunction with a Medicare-approved ASC procedure code.

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