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L8683 and ASCs

Mary Posted Tue 03rd of September, 2019 14:10:58 PM
Can an ASC bill L8683 to Medicare?
SuperCoder Answered Wed 04th of September, 2019 04:03:56 AM

Hello Mary,

Thank you for your question.

 

HCPCS code L8683 (Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver) is not an ASC approved procedure.

 

Medicare does not allow separate payment for implanted neurostimulator devices (L8683) in an Ambulatory Surgical Center (ASC). The surgical procedure codes are device-intensive procedures and reimbursement for the implants is included in the payment for the surgical procedure.

 

 

Hope that helps!

 

Thanks

Mary Posted Thu 05th of September, 2019 12:52:21 PM
Hi Leesa-The L8683 is not on the Medicare ASC fee schedule it is on the DME fee schedule as an orthotic, prosthetic external device. Would this be acceptable to submit to Medicare since it is on the DME fee schedule and has payment attached? Also, if so is a revenue code such as Code 274 for prosthetic/orthotic devices needed for it if submitted on a UB?
SuperCoder Answered Fri 06th of September, 2019 07:42:11 AM

Hello Mary,

Thank you for your additional query.

 

There can be two scenarios for the above provided documentation.

 

1). Either the provider will report for his part of services (i.e. procedure performed) and the DME supplier will report for the item supplied to the facility; individually.

 

2). The facility will report the entire claim on behalf of provider/ and DME supplier to the Medicare for reimbursement. Providers are not entitled to bill for DME.

 

In order to report this code (L8683) in UB-04 form, the service(s) must be rendered under facility setting.

 

Hope that helps!

 

Thanks

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