# Novasure Ablation Reimbursement



## karey (Jan 15, 2009)

Does anyone know how to get the maximum reimbursment for a Novasure Ablation. I code 58353 for Endometrial ablation w/o hysteroscopy & I use 58563 for endometrial ablation w/ hysteroscopy. The ablation w/ the hysteroscopy is the one that is more expensive and we are only getting reimbursed $300-$400. That's not even half of what we bill for the procedure! Please help!  

Karey,CPC


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## amjordan (Jan 16, 2009)

First are these being done in office or at a facility?  Normally, facility reimbursement is lower because you don't have the same overhead that you do in the office.  As an example, I have provided our Medicare reimbursement for these codes below.  As you can see, the reimbursement for the procedure in a facility (Hospital, Surgicenter) is less then the non-facility (Office).  So you need to consider where you are doing the procedure and check to see if your place of service code it correct on your claims.

Non-Facility  58353    $1024.82
Facility        58353      $209.89

Non-Facility  58563    $1669.68
Facility        58563      $332.61

You also need to take a look at the fee schedules for all of your insurance contracts and see if they include facility and non-facility reimbursement as well.

Angela Jordan, CPC
Manager Coding & Compliance
Women's Healthcare Network, LLC


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