Medicare Compliance & Reimbursement

Reader Questions:

Medicare Won't Cover Trays

Question: How do I code products like laceration trays for minor wounds, suture trays, facet tray, lumbar puncture tray, etc.?

Answer: Some private payers may pay for trays with either the HCPCS level II code (A4550, Surgical trays) or the generic CPT supply code (99070, Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [List drugs, trays, supplies, or materials provided]). HCPCS Level II 2010 does not contain specific codes for each tray type. For insurers that accept the CPT miscellaneous supply code 99070, include the item description on the claim form.

Warning: Medicare does not pay separately for trays and bundles them into the payment for the surgical code, such as laceration repair. The payment for the surgical code includes the practice expense associated with the tray.

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