No codes, no pay for devices that cross total occlusions

Why This Topic Matters

The topic affects whether a preparatory occlusion-crossing service can be separately reported or paid, which has direct implications for claims processing, documentation, and reimbursement strategy.

Article Sections

1. Coding and reimbursement issue for total occlusion crossing devices

   Introduces the reporting question raised by devices used to cross total occlusions and the general payer concern surrounding separate payment. The section frames the service within interventional procedures and reimbursement policy.

2. Reader question and vendor perspective

   Summarizes a reader’s billing question about the technology and an expert response about how the service is viewed by payers. The discussion centers on reporting concerns and the status of related payment handling.

3. CMS and industry response

   Describes the manufacturer’s request for new coding recognition and the CMS HCPCS Workgroup’s response. It also notes ongoing efforts by industry and professional organizations to pursue future code development.