CARDIOVASCULAR
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Peripheral

Find reimbursement resources, including coding guides and links to Medicare Coverage Determinations, pertaining to peripheral interventions.

 

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

 

Providers should consult with their payers regarding appropriate documentation, medical necessity and coding information consistent with individual payer requirements and policies.

Coding Guides and Resources

Ambulatory Surgical Center and Office Based Lab Reimbursement Guide

Medicare coding and payment guide for procedures performed in ASC and OBL settings

Common CPT Code Modifiers

Printable form for easy CPT coding reference

HCPCS Device Category C-Codes Guide

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

Physician Fee Schedule

Medicare coding and payment guide for physicians performing vascular procedures

Webinars

2021 Medicare Reimbursement and Coding Webinar Focused on Endovascular Lower Limb Procedures

This webcast will address Medicare reimbursement for Endovascular Lower Limb procedures. It provides an overview of the basics in coding and reimbursement for lower extremity revascularization procedures. The program also includes common patient/case scenarios and how to appropriately code and report to Medicare.

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.

Commercial Coverage Information

Commercial Coverage of peripheral interventions may vary. For reimbursement purposes, Abbott Vascular recommends that providers verify insurance coverage prior to performing a procedure.

Lower Extremity Endovascular Revascularization Prior Authorization Toolkit

Abbott offers this Lower Extremity Endovascular Revascularization Prior Authorization Tool Kit for use by physicians and their offices when seeking prior authorization or submitting claims requiring such pre-procedure approvals. This comprehensive tool kit includes information to assist your office in submitting prior authorization requests to confirm coverage for patients who may benefit from a lower extremity endovascular revascularization procedure. Download the guide and the accompanying forms using the links below.

Tool Kit Instructions

Download this guide for submitting prior authorization requests for your patients. It includes instructions on how to use this tool kit and the associated forms.

Prior Authorization Checklist

Download this checklist for submitting prior authorization requests for your patient. The checklist includes a summary of the information used to process prior authorization requests for lower extremity endovascular revascularization procedures.

Sample Letter of Medical Necessity

Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior authorization request for lower extremity endovascular revascularization procedures. Physicians should customize the letter based on the patient’s actual medical history and diagnosis, and to be consistent with any specific prior authorization requirements.

*This Tool kit provides suggested instruction and summary of guidelines for facilitating their prior authorization requirements. It is not an endorsed resource of any benefit provider as providers are highly encouraged to review each benefit provider's policy and requirements for prior authorization and medical guidelines.

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.