tci Part B Insider - 2003 Issue 17

Bad Coding for New Devices Hits Physicians in the Wallet

Carriers Plan Massive Take-BacksThe Food and Drug Administration only just approved the first drug-eluting stent last April, and it's already getting providers into trouble.   The Centers for Medicare & Medicaid Services said hospitals could start billing for drug-eluting stents using HCPCS G0290 and HCPCS G0291 effective July 1, according to Trans-mittal A-03-051. Those codes reimburse about $5,000 each, or nearly three times the codes the hospitals had been using for outpatient stent insertion prior to July 1: 92980 and 92981.  But many physician coders misunderstood the CMS instruction and thought they had an open...

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