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MitraClip Billing Checklist Released

<ѻý class="mpt-content-deck">— Guide describes code modifiers and when to use them
MedpageToday

The Society for Cardiovascular Angiography and Interventions issued a guide -- in conjunction with Abbott Vascular -- for MitraClip mitral valve device operators and echocardiographers on filing insurance claims.

The , which is effective for calendar year 2016, includes descriptions of each applicable CPT code, along with the national average payment for each procedure. The document also clarifies coding modifiers for mitral valve repairs with multiple operators (-62) and those to be enrolled in the (-Q0/-Q1).

Reimbursement has been a barrier with MitraClip. In 2014, following warnings that the Medicare payment rate was so low that cardiologists would stop providing MitraClip therapy, the Centers for Medicare and Medicaid Services included the device in the New Technology Add-on Payments program. This measure reimburses operators for half the $30,000 price tag of the MitraClip in addition to the coded payments.

Making the MitraClip more accessible in the U.S. "is another important step for the advancement of percutaneous mitral valve therapies. There are some patients out there who are not good candidates for surgery but who will be undoubtedly helped by the MitraClip therapy," , president of CVPath in Gaithersburg, Md., told ѻý.

  • author['full_name']

    Nicole Lou is a reporter for ѻý, where she covers cardiology news and other developments in medicine.

Disclosures

Virmani disclosed relationships with 480 Biomedical, Abbott Vascular, BioSensors International, Biotronik, Boston Scientific, Lutonix, Medtronic, Merck, MicroPort Medical, OrbusNeich Medical, SINO Medical Technology, Terumo Corporation, and W.L. Gore.

Primary Source

The Society for Cardiovascular Angiography and Interventions Foundation

"2016 MitraClip physician coding and payment guide" SCAI 2016.