I have Medicare as my insurance. They covered my surgery and now I want to see if they cover fills. Does anyone know the CPT code for fills? One that they have used and it was covered. Anyone with Medicare been able to get the fills paid for? Any help would be greatly appreciated. Thank you.

Stephanie

I have researched the Medicare online site to find a codeSince I did not see any response from your query. I have not had the surgery yet so don't know if these are acceptable for Medicare from first hand experience.

I found :

New code

44.95 Laparoscopic gastric restrictive procedure

Adjustable gastric band and post insertion

Excludes: Laproscopic gastroplasty (44.68)

other repair of stomach (44.69

44.98 Laparoscopic adjustment of size of adjustable gastric restrictive device

Infusion of saline for device tightening (88.76)

Withdrawal of saline for device loosening

Code also any:

Abdominal ultrasound (88.76)

Abdominal wall flouroscopy (88.09)

Barium Swallow (87.61)

What is strange about those is that they are actually ICD-9 codes.

ICD-9 codes are diagnosis codes (International Classification of Diseases- 9th edition). In order to justify an intervention (such as surgery) you need to provide the diagnosis code.

CPT (Common Procedural Terminology) Codes are generally codes for an intervention.

What is strange with those set of codes is that those series of codes are ICD-9 codes for operations; and CPT codes are usually used for operations. For example for many insurnace companies we use :43659Unlisted laparoscopy procedure, stomach

I'll have my biller look into it. I'm particularly interested because my wife and I performed several Lap Bands for Medicare that they subsequently refused to pay for( :cross-eye ). Maybe if we use some of those codes they will pay for them. (I'll owe you lunch Sandybells!)