Retroactive Billing Medicare for Drug Coated Angioplasty Balloon Code C2623 with AV Dialysis Intervention Codes

Medicare is allowing pass-through payment for code C2623 with AV dialysis interventions for claims filed retroactively for dates of service from August 25, 2017, through December 31, 2017. Pass-through payment wasn’t made with this combination in 2017 due to Medicare not changing its limited coverage for the catheter’s use only in the femoral popliteal arteries. Effective January 1, 2018, pass-through payment for code C2623 ended.

December 2017 Q & A

Question: Drug Eluting Balloon C2623 with CPT 36902

Our facility is performing the AV angiography of the dialysis circuit as described in CPT code 36902. The surgery department is using the device code C2623 for the drug eluting balloon that is documented as being used by the surgeon. We are receiving denials that the drug eluting balloon code does not have a matching CPT code. From what I can find, it appears that drug eluting balloon code C2623 can only be used with fem/pop procedures; is this correct?

November 2016 Q & A

Question: Cutting Angioplasty with Perforation

May 2016 Q & A

Question: Angioplasty of the iliac with the sheath?

March 2016 Q & A

Question: Angioplasty or Primary Thrombectomy with No Stenosis Documented