Reimbursement/Collections Tips

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Billing Surgical Trays In An Office Setting  

A surgical tray is a sealed set of reusable or disposable instruments that are opened for use in a surgical procedure.  The codes associated with the instruments are 99070 and A4550. If you try to bill separately for the surgical tray, it will likely be denied because commercial carriers consider their use to be inclusive to the evaluation and management fee.  If your practice uses many surgical trays, the best way to be reimbursed is to have the insurance carriers factor their cost into the RVU's or contractual allowances for your practice. Addressing the cost on the contract side will save you denials on the billing side.  

Medicare will allow infrequent surgical tray billings for certain procedures. Breast Biopsy (19101), Cyst Excision (19120) and Lesions separately identified by a radiological marker. (19126) are reimbursable using HCPCS A4550. However, such procedures are outside of an office setting.  

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