Reimbursement and Coding

• Ambulatory Surgical Center and Office Based Lab Reimbursement Guide

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

• 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

• Thrombectomy and Thrombolysis Reimbursement Guide

  Medicare coding and payment guide for thrombectomy and thrombolysis procedures performed in the inpatient, outpatient, ASC, and OBL settings

• Atherectomy Reimbursement Guide

  Medicare reimbursement and coding guide for atherectomy in lower extremity endovascular procedures in hospital inpatient, hospital outpatient, ASC and OBL settings

• 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.

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.