Reimbursement
Most carriers provide coverage for EVLT® (see list) when medically necessary, using the following codes:
| Codes for EVLT®: |
| 36478: |
Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser, first vein treated. |
| 36479: |
Second and subsequent veins treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure) |
Of the numerous health insurance plans in the Unites States, many follow Medicare policy, however private payer requirements may vary. The unadjusted national average Medicare reimbursement for an in-office procedure, established by the Center for Medicare and Medicaid Services (CMS) for 2006 is:
| 36478: |
$1.953.56 for office-based procedures and a professional payment of $348.38 when services are provided at a facility. |
| 36479: |
$418.57 for office based procedures and a professional payment of $170.03 when services are provided at a facility. |
Hospital outpatient departments (HOPD) are compensated based on the applicable ambulatory payment classification (APC) – 0092. Ambulatory Surgical Centers (ASC) are compensated based on Group 3 payment
AngioDynamics, Inc. is committed to providing its customers with reimbursement support materials for use in conjunction with EVLT®. We provide a guide designed for those people responsible for payer relations, coverage and/or pre-certification and the billing and reporting of services provided to the patient. In the event that your local carrier has not provided a written coverage policy for EVLT®, you may find it helpful to contact your Provider Relations Representative or Medical Director and introduce them to the EVLT®. AngioDynamics will provide an introductory letter and other necessary documentation that you may use for this purpose.
The new codes and the Medicare reimbursement rate are expected to be reflected in contracts with commercial carriers per their usual and customary practice. The investment in EVLT® is revenue generating and provides an immediate return on investment. Please contact your AngioDynamics Sales Consultant for further clarification of your personal return on investment.
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