Reimbursement Coding Targeted Drug Delivery

INFORMATION ON CODING

To ensure that a patient meets the medically necessary policy criteria, or to find out if coverage prior authorization/pre-determination is required, please contact the patient's payer directly. Medtronic provides this information for your convenience only. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. The information below provides assistance for FDA approved or cleared indications. More

The coding includes information on the diagnosis and procedure codes applicable to all sites-of-service to be used when billing, along with Medicare National Average payment rates. For specific coding assistance with your facility, please contact your local Health Economics Manager.

The codes in the documents below are up to date through:
MPFS – 12/31
OPPS and ASC – 12/31
IPPS – 9/30

TARGETED DRUG DELIVERY FOR CHRONIC PAIN AND CANCER PAIN

HOSPITAL, PHYSICIAN AND ASC CODES

  • ICD-10-CM Diagnosis and Procedure Codes
  • HCPCS Device and Drug Codes
  • Device C-codes and Device Edits
  • CPT® Procedure Codes
  • MS-DRG Assignments

Medtronic provides this information for your convenience only. It is not intended as a recommendation regarding clinical practice. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. This document provides assistance for FDA approved or cleared indications. Where reimbursement is requested for a use of a product that may be inconsistent, or not expressly specified in the FDA cleared or approved labeling (e.g., instructions for use, operator's manual, or package insert), consult with your billing advisors or payers for advice on handling such billing issues. Some payers may have policies that make it inappropriate to submit claims for such items or related service. Contact your Medicare contractor or other payer for interpretation of coverage, coding, and payment policies.