| by AJ Riviezzo |
| The largest coding/reimbursement change for phlebology practices is the decrease in phlebectomy reimbursement. The 10-20 stab phlebectomy has dropped 31.49 percent and the 20+ stab phlebectomy has dropped by 32.6 percent. With the National Average Reimbursement for the two codes now set at $457.26 and $534.85 this can represent a significant decrease in revenue.
On the ‘plus’ side, you may or may not see a corresponding reduction in your reimbursement by commercial payers. Not all commercial plans tie their fee schedule to the most current year Medicare fee schedule. The Advantage plans will decrease, but your commercial PPO and HMO plans may not. You should have your billing team review to see which payers did or did not change their reimbursement rates when some of your January claims start paying.
The other notable yet positive change to the phlebectomy codes is the global period for the phlebectomy is changing from 90 days to 10 days. The change is significant in that you will be able to bill for follow up office visits after the ten-day global period has expired. |
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