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Simplicity Probe

Nancy Posted Mon 21st of June, 2010 13:11:10 PM

When the physician does RFAs can he bill the patient for the simplicity probe when it is not covered by insurance or is this inclusive to the procedure? Thanks again for your help.

SuperCoder Answered Tue 22nd of June, 2010 08:20:08 AM

There is no specific code for a simplicity III probe used for RFA. You may try the unlisted procedure code 64999 or go for the regular RFA codes 64622-64623.

Nancy Posted Tue 22nd of June, 2010 11:56:31 AM

Can you bill the patient? Thanks

SuperCoder Answered Wed 23rd of June, 2010 07:34:43 AM

I assume you are a pain clinic and do your own procedures in office and are not talking about the physician doing the procedure at the hospital (where the hospital bills for the supplies.) In general the parts are covered with the procedure. If you want to use something special that you definitelty know is not covered by the insurance, you need to look at your contract to see if you can bill the patient for non-covered services and if so I would get a signed letter from the patient that they agree to pay. For Medicare you need to use the official ABN form if this is a non-covered Medicare service.

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