tci Outpatient Facility Coding Alert - 2013 Issue 3

Reimbursement: Think Twice About Billing Infrared Therapy Treatments

Heed what CMS says about reimbursing 97026. Providers with some therapy clinics tend to lean toward using infrared therapy to treat patients with diabetic neuropathy (357.2, Polyneuropathy in diabetes), but keep one thing in mind before submitting those claims: CMS doesn’t take the same stance. After going without a finalized national coverage determination (NCD) for quite some time, now infrared therapy is clearly a non-reimbursable treatment, Medicare says. Clear Up Coverage Confusion This national coverage determination might seem to contradict what you have heard in the past. For example, a lot of miscommunication has been floating around...

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