Wiki PLEASE HELP WITH C1713 CODING

[cherylbr]

Can anyone direct me on where I can find information on the billing of wasted surgical hardware code C1713 such as screws & pins.
I would like to know the details as far as if it is billable if it enters the body but could not be used for breaking or wrong size.
Also, if the item falls on the floor and never touches the patient's body.
Does Medicare have detailed explanation on this?
Can anyone please give me what guidelines they are currently using for this?

Thank you,
Cheryl

 

[kkidd91]

Can anyone direct me on where I can find information on the billing of wasted surgical hardware code C1713 such as screws & pins.
I would like to know the details as far as if it is billable if it enters the body but could not be used for breaking or wrong size.
Also, if the item falls on the floor and never touches the patient's body.
Does Medicare have detailed explanation on this?
Can anyone please give me what guidelines they are currently using for this?

Thank you,
Cheryl

Hi Cheryl,

I do not have any detailed documentation on billing wasted hardware. I am interested in reading the responses as well. I work for an outpatient ASC, and we never bill for wasted hardware as in the scenarios described above, they are marked in inventory as wasted and never billed to the insurance. Our facility does not bill C1713 to Medicare as it is inclusive to the procedure in our ASC contract.

 

[CBLENNIE]

if it is billable if it enters the body but could not be used for breaking or wrong size.

From a payer standpoint we would not pay for hardware that was wasted because it broke or the wrong size was selected for use for a given patient, a health plan should only be paying for medically necessary services and items actually received by the patient.

For an item that broke during the procedure you might want to check to see if there was a defect and the manufacturer should replace the item or credit your facility for the wasted item. For an item that is wasted because the wrong size was selected, the cost of the wasted item is part of the cost of doing business for the facility, as the incorrect size was selected by either the physician or a staff member, not the patient or health plan.

From a patient perspective, why should they be responsible for these items when they didn't receive the item through no fault of their own. How would you feel if you were the patient and billed for these items?

There are a lot of things that are part of the cost of doing business and should be built into the cost of running a practice or facility because not everything should be paid for by an insurance company and/or patient. Are you billing the patient for the amount of electricity used to run the OR during their procedure? Somethings are inherently part of running a practice or facility.