Wiki Drug Eluting Stents

[kwashburn13]

Our billing department has asked that we research whether or not the first DES inserted is included in the procedure. So far anything our auditing department has been able to find has been vague. Can anyone here help?? Is the first DES (the supply itself) included in the primary procedure, or is it separately billable?

Thank you!

 

[thomas7331]

If you're billing a facility claim, you would include the charge for the stent on the claim (probably HCPCS codes from the range C1874-C1877, depending on how your payers want it billed). Depending on the payer and contract, you may or may not get additional reimbursement for itemizing it as a separate charge - Medicare packages the stent cost into the APC rate it pays for the entire procedure, but does require the device code on the claim.