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HCPCS/REV Code for Implants (coils, Melody valve, duct occluders)

Date: Jan 21, 2019

Question:

What is the appropriate HCPCS code for device without a C-code (L8699 vs C1889)? For implants we assign revenue code 278 and L8699 for C-code. We get Medicaid denials that do not allow L8699, then a denial for submitting 278 without a C-code. We tried C1889 as well, but are getting same denials. If procedure is not device dependent with a specific implant device code, is it appropriate to use 272 REV code instead? These are not inpatient accounts.

Question ID : 11956
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