# TAVR claims



## mdm58 (Jul 31, 2014)

Is anyone getting TAVR claims paid? Medicare is denying invalid or missing Clinical Trial # but it is on the claim. 
If anyone knows how to get these pd please email me @ mmunsey@mc.utmck.edu

Thanks


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## Robbin109 (Aug 4, 2014)

What CPT are you billing?


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## mdm58 (Aug 4, 2014)

*TAVR codes*

33366 mostly


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## mdm58 (Aug 4, 2014)

*TAVR codes*

We are billing 33366  62 & Q0  modifiers dx 424.1 V70.7 claims are denying invalid CT #


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## twizzle (Aug 4, 2014)

denisemunsey said:


> We are billing 33366  62 & Q0  modifiers dx 424.1 V70.7 claims are denying invalid CT #



Are you entering the clinical trial number on your claims?

If not they will deny.


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## mdm58 (Aug 4, 2014)

*Tavr*

Yes I am entering the CT # on line 19 of the 1500 form


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## Robbin109 (Aug 4, 2014)

What clinical trail number are you using and where on the claim are you putting it?


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## Robbin109 (Aug 4, 2014)

You can verify your Clinical trial # here:

http://clinicaltrials.gov/ct2/results?term=tavr&pg=2

I *think* it goes under box 23...


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## Robbin109 (Aug 4, 2014)

I'm not sure if this will help you, but there is a lot of great info here:

http://www.cms.gov/Medicare/Coverag...ory-Clinical-Trial-Identifier-Number-QsAs.pdf


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## mdm58 (Aug 5, 2014)

*Tavr billing*

So if I have rounding charges and a charge for a TEE while the patient in In house for a TAVR procedure all charges have to be billed with the Q0 modifier?


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## carolt (Aug 28, 2014)

*TAVR coding*

what approach is the physician using to place the TAVR? If it is the open femoral artery approach you will bill 33362 with 62 Q0 modifier. using the diagnosis codes of 424.1 and v70.7. The clinical trial # needs to be in loop 837P for Medicare. If you don't know where that is ??? you need to check with your system techs to find out. We use GEMMS and it is an area under episode information on our claims. It took us quite awhile to find all of this out. 
As far as the coding for after care procedures you can bill for them but do not need any modifiers on them, we are finally getting paid for all of our claims, past and present. 
Good luck


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## Marybeth (Sep 2, 2014)

*Tee w/rounds for tavr*

Only the tavr procedure gets the q0 which means that the patient is in a study


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