# latera C9749



## trose45116 (Jan 15, 2019)

How many code for this and do you code the implant separately?


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## b.cobuzzi (Feb 14, 2019)

The C code for Latera can only be used by facility billing, for ASC or OR facility.  It is a pass through so they can get paid for the implant in addition to their grouper.  A physician cannot bill the C code and get paid for it.

Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
Consulting Editor Otolaryngology Coding Alert
www.CRNHealthcare.com
b.cobuzzi@att.net


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## tdesher (Feb 26, 2019)

*Follow up question*



b.cobuzzi said:


> The C code for Latera can only be used by facility billing, for ASC or OR facility.  It is a pass through so they can get paid for the implant in addition to their grouper.  A physician cannot bill the C code and get paid for it.
> 
> Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
> Consulting Editor Otolaryngology Coding Alert
> ...



Does that mean I can bill the C9749 alone and get paid? I work in an ASC and we are looking to perform our first one of these. I see a lot of threads saying to use the 30999 but this code is on the ASC not allowable list.  I wasnt sure if I could bill the C code as the one and only


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## b.cobuzzi (Mar 6, 2019)

I believe so, Tdesher.  I suggest you contact the reimbursement line for Stryker (now owns Entellus) and they should be able to answer your questions.

Barbara Cobuzzi


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## Henson65 (Apr 30, 2019)

trose45116 said:


> How many code for this and do you code the implant separately?



I sent an email to the rep in regard to coding/billing this in the ASC setting and this is the information I received:

"If you are billing Facility Fees, you would use C9749 for the procedure and C1889 for the implant—when billing for Medicare patients. There are some random payers that accept the C codes, but we don’t have a list of the payers that do. If you bill the C codes, you may or may not get additional payment for the device. That varies by payer. (The L8699 code is a potential option, but the C1889 code description mentions that it’s for a device-intensive procedure, which is what LATERA is.)"


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