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CARDIOVASCULAR
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Vascular

Find reimbursement resources, including coding guides, links to Medicare Coverage Determinations, on-demand webinars, and frequently asked questions pertaining to coronary interventions.

 

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Contact our Health Economics and Reimbursement Department for additional information or assistance. 

 

Coronary

Local Medicare Administrative Contractors (MACs) as well as other third party payers have their own coverage policies for coronary interventions and devices. You should contact your local Medicare Contractor and third party payers for information on their specific coverage policies for interventional cardiology. There is currently no national Medicare coverage decision for coronary interventions. Most local Medicare Contractors, Fiscal Intermediaries and/or Carriers have posted their Local Coverage Determinations (LCD) on interventional cardiology on their websites. You can find a list of Medicare Administrative Contractors, Fiscal Intermediaries and Carriers at the CMS webpage.

Coding guides and resources

Coronary Interventions Coding Guide

Medicare coding and payment guide for coronary procedures, including Fractional Flow Reserve (FFR) and Optical Coherence Tomography (OCT) procedures

Chronic Total Occlusions (CTO) Guide

Medicare coding and payment guide for coronary artery chronic occlusion procedures

ACC-SCAI Coding Recommendation for RFR

Society provided coding recommendations

Common CPT Code Modifiers

Printable form for easy CPT coding reference

C-Code List by Product

Printable form for easy CPT coding reference

HCPCS Device Category C-Code

Current list of reimbursement Healthcare Procedural Coding System (HCPCS) Device Category C-codes

Medicare local and national coverage determinations

Medicare Local Coverage Determinations (LCDs)

In the absence of a national coverage policy, an item or service may be covered at a local basis. Check here for a list of CMS policies that provide Medicare beneficiaries coverage in certain locations across the country.

Medicare National Coverage Determinations (NCDs)

Developed through an evidence-based process, check here for a list of CMS policies that provide coverage for all Medicare beneficiaries.

Vessel closure details

The following code has been assigned to occlusive devices by CMS: G0269

G0269 is defined as: placement of an occlusive device in either a venous or arterial access site, post-surgical or interventional procedure.

Code G0269 should be used on Medicare claims to record the placement of the vasoseal and for other payers as directed.

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HE&R Disclaimer

This document and the information contained herein is for general information purposes only and is not intended, and does not constitute, legal, reimbursement, business, clinical, or other advice. Furthermore, it is not intended to and does not constitute a representation or guarantee of reimbursement, payment, or charge, or that reimbursement or other payment will be received. It is not intended to increase or maximize payment by any payer. Similarly, nothing in this document should be viewed as instructions for selecting any particular code, and Abbott does not advocate or warrant the appropriateness of the use of any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third-party payers. In addition, the customer should note that laws, regulations, and coverage policies are complex and are updated frequently, and, therefore, the customer should check with its local carriers or intermediaries often and should consult with legal counsel or a financial, coding, or reimbursement specialist for any questions related to coding, billing, reimbursement or any related issues. This material reproduces information for reference purposes only. It is not provided or authorized for marketing use.

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DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.