REIMBURSEMENT VERTEBRAL AUGMENTATION PROCEDURES

 

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REIMBURSEMENT CODING AND PAYMENT GUIDES

To ensure that a patient meets the medically necessary policy criteria, or to find out if coverage prior authorization/predetermination 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.

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 Medtronic sales or health economics representative.

pdf Balloon Kyphoplasty Reimbursement Guide (.pdf)

ICD-10 codes, CPT codes, and Medicare average payment rates for balloon kyphoplasty (BKP).

829KB

DOWNLOAD BKP GUIDE
pdf OsteoCool & OsteoCool Plus Premium Vertebroplasty System or Balloon Kyphoplasty Reimbursement Guide (.pdf)

ICD-10 codes, CPT codes, and Medicare average payment rates for osteocool & osteocool plus premium vertebroplasty system or balloon kyphoplasty.

990KB

Download OsteoCool and BKP Guide
pdf Vertebroplasty Reimbursement Guide (.pdf)

ICD-10 codes, CPT codes, and Medicare average payment rates for vertebroplasty.

820KB

DOWNLOAD VERTEBROPLASTY GUIDE

LCD Requirement Sample Checklists (By MAC) and additional resources

Please utilize the below checklists to confirm that LCD requirements are met. These resources are made available by Medtronic to assist healthcare professionals in completing the reimbursement process. Additionally, Medtronic provides reimbursement resources for patients with no previous history of osteoporosis.

pdf FCSO LCD Requirement Sample Checklist (.pdf)

Medicare (FCSO) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

116KB

pdf NGS LCD Requirement Sample Checklist (.pdf)

Medicare (NGS) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

107KB

pdf CGS LCD Requirement Sample Checklist (.pdf)

Medicare (CGS) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

114KB

pdf Novitas LCD Requirement Sample Checklist (.pdf)

Medicare (Novitas) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

116KB

pdf Noridian LCD Requirement Sample Checklist (.pdf)

Medicare (Noridian) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

119KB

pdf Palmetto LCD Requirement Sample Checklist (.pdf)

Medicare (Palmetto) Percutaneous Vertebral Augmentation (PVA) for osteoporotic VCF LCD requirement sample checklist.

103KB

pdf VCF Resource For No History Of Osteoporosis (.pdf)

Reimbursement resources for Vertebral Compression Fracture with no history of Osteoporosis.

265KB

pdf WPS LCD Requirement Sample Checklist (.pdf)

Medicare (WPS) Percutaneous Vertebral Augmentation (PVA) for VCF LCD requirement sample checklist.

121KB

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