# Impella 2.5



## dwoody (Dec 1, 2011)

We are new to billing this device. Our physician is billing on one date of service the insertion 33999,   removal 33999, repositioning 33215 and repair of blood vessel 35286. He documents sucessful placement and removal, he also documents repositioning of the Impella during the PCI. He does not document repair of the blood vessel. 

Are we looking at correct CPT codes?  Can he bill for the  insertion and removal? He states he repositioned three times during the procedure.  Can he bill this also?  Or is that code for repositioning after the procedure is completed? Is it standard to charge for a repair code? 

Any feedback is greatly appreciated.  Need to know ASAP.


----------



## jewlz0879 (Dec 2, 2011)

I wouldn't bill for repair of blood vessel. He's utilizing the b.v. as means of Impella insertion, correct? If so, to me that is the same principle as not billing for femoral closure during heart cath; if it was opened it has to be closed and therefore not separately billable. 

Without seeing the report, I'm not sure I'd bill the 33215 for repositioning because 33215 relates to "repositioning of previously implanted PM or ICD electrode;" not for an Impella. 

I don't understand why he would bill for the insertion and removal on the same day but I suppose if it were done in that manner, he could. 

Yes, we also use the unlisted code for the Impella 2.5. 

Go here: http://www.abiomed.com/medical-professionals/reimbursement/

And they will send you immediate reimbursement and how to bill for Impella 2.5 and 5.0.


----------



## leahlhaynie (Dec 7, 2011)

The documentation we received from Abiomed gave 33975 for insertion and 33977 for removal. We don't have problems getting 33975 paid, but we have a lot of problems with 33977. Your mileage may vary.


----------



## cweavercpc (Dec 12, 2011)

*Impella*

You should check with you carrier for more specific guidlines.  But with my experience for billing these to Cahaba GBA, these would not pay for assistance during a PCI.  Medicare went by the NCD 20.9 at the following link:

http://www.cmms.hhs.gov/medicare-co...ails.aspx?NCDId=246&ncdver=5&bc=AgAAQAAAAAAA&

also found in the NCD is this link that shows approved facilities for use of the VAD for Destination Therapy (assuming this is not a transplant patient) and you will need to make sure your facility is listed.  

http://www.cms.gov/MedicareApprovedFacilitie/VAD/list.asp#TopOfPage

Also if inserted and removed the same day you would only bill the 33999 once, it would only pay if removed on a different DOS. 

There are also more forums found on here regarding IMPELLA that may help.

I hope this helps.


----------

