Wiki FMT (Fecal Microbiota Transplant) Assistance - Coding

[marianne202]

All,

I'm looking to connect with anyone who has coded, billed or audited for FMT procedures. We are embarking on this new process and while our local MAC doesn't cover it and our commercial payers want a G code, our providers say they have been told it can be billed using a diagnostic colonoscopy code. I'm looking for others who would be willing to discuss their journey on providing these services and who may have worked with payers or a MAC on how to correctly code these procedures.

Thanks!
Marianne

 

[TamGIGal]

Hi - my physicians have been performing fecal transplants. The GI Lab/Hospital purchases the Fecal material, the patient signs ABN/ANN and pays for this material upfront. The MD performs the colonoscopy (GI Lab RN/Hospital Staff puts the fecal material in), MD charges for colonoscopy only since this is all he performed using C. Dig diagnosis. I am not aware of having any issues with the colonoscopy being denied.

I know the hospital bills out their portion and if they receive payment for the fecal material, they reimburse patients.

Hope this helps.