Wiki Iovera

[kimberly.hess@thedacare.org]

Hello everyone,

Does anyone have any experience billing Iovera? I know the Iovera website says to bill cpt 64640 but we have information from the AMA to bill unlisted code 64999. The problem is we can't seem to get this paid by any payer, except Network. Is anyone billing Iovera successfully?

Thanks

Kim, CPC, COSC

 

[pscanlan]

Hello everyone,

Does anyone have any experience billing Iovera? I know the Iovera website says to bill cpt 64640 but we have information from the AMA to bill unlisted code 64999. The problem is we can't seem to get this paid by any payer, except Network. Is anyone billing Iovera successfully?

Thanks

Kim, CPC, COSC

I can't say that I've billed it, so I'm not much help. I have billed under similar circumstances though. All I can say is, FDA-approval is not the same as insurance approval. I'd have your clinical staff or intake staff draw up a short form (based on below link), stating that the patient is aware that this service will in all likelihood not be covered by their insurance, and that they will be responsible for any charges not covered. If they still wish to proceed, at least they're forewarned that it won't be covered. This is just good practice for any service that you know or suspect won't be covered by insurance. It's called an advanced beneficiary notice of noncoverage. See Here for more info.

I realize your provider may not want to balance bill the patient, but that may be what it takes to get paid for this service. That, or only agree to perform this service for cash-pay patients. At least, until insurances start covering it.

Sorry I couldn't speak to Iovera specifically, haven't even heard of it honestly.

 

[kimberly.hess@thedacare.org]

Thank you for your reply and the good advice