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At
present, the ML830™ Laser does not have its own
billing code, because, as is the case for other new
technologies, the issuance of a new billing code can take
years. (Note: The ML830™ Laser received FDA
permission to market in 2002). In the interim, physicians
routinely employ a "best fit" approach when
employing new technologies. For example, arthroscopy and CAT
scan evaluations did not have their own billing codes for
many years. When no specific code is available, physicians
have been instructed to use the closest appropriate billing
code or the unlisted procedure code in the most appropriate
section of the Physicians' Current Procedural Terminology (CPT
2002, Professional Edition, American Medical Association,
Chicago, IL, 2000.)
Presently, the most frequently
used billing code has been a Physical
Medicine and Rehabilitation Constant Attendance code 97039
Unlisted Modality (specify
constant therapy for 30 minutes).
This is billed per unit (15 minutes) basis
so anything over 15 minutes is two units. The use of
this code is recommend based on policies determined in
response to inquiries to various local insurance entities
throughout the country and
Workers' Compensation Commission Guidelines.
Generally, with first time claims with a specific carrier,
an explanation is enclosed stating that the code being
submitted for a new therapy recently approved by the FDA.
Actual amounts of reimbursement can vary widely according to
location and carrier. |