tci Medicare Compliance & Reimbursement - 2007 Issue 34

CODING: Is Your Practice Losing $160 Every Time You Bill 55876?

Best bet: Be prepared to submit invoices and CPT book photocopiesMyth: You can't ever bill separately for fiducial markers.Reality: Some carriers will pay for these gold markers on occasion, and you can always appeal on an individual basis by submitting an invoice.Many providers have faced confusion over fiducial marker coverage since CPT 2007 introduced a new code, 55876. This code, for placement of interstitial device(s) for radiation therapy in the prostate, has a note in its descriptor: "Report supply of device separately." But just because you can report something separately doesn't mean that Medicare will pay...

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