IDET™
INTRADISCAL ELECTROTHERMAL™ Therapy
APC Changes
CMS increases IDET◊ procedure reimbursement level over 130%
In November 2005, the Centers for Medicare and Medicaid Services (CMS) announced it would increase IDET◊ procedure reimbursement by placing it in a more appropriate Ambulatory Payment Classification (APC) for calendar year 2006:
- Under the reclassification, CMS will reimburse $1424.50 for the IDET◊ procedure in 2006, instead of the 2005 payment level of $600.85. This represents a percent increase of at least 130%.
- The CMS agreed that the previous assignment of the IDET◊ procedure to APC 0203 did not describe the clinical features or hospital resources associated with CPT codes 0062T (percutaneous intradiscal annuloplasty, any method, unilateral or bilateral including flurorscopic guidance; single level) and 0063T (percutaneous intradiscal annuloplasty, any method, unilateral or bilateral including fluoroscopic guidance; one of more additional levels).
- CMS agreed that assigning the procedure to APC 0050 (Level II Musculoskeletal Procedures except Hand and Foot) would achieve more clinical and hospital resource homogeneity.
- The Medicare fee schedule is tied to workers’ compensation reimbursement in many states (including California), further extending the reimbursement reach of the IDET◊ procedure.
| Year |
APC |
Description |
Payment rate |
| |
|
|
|
| 2006 |
0050 |
Level II Musculoskeletal Procedures |
$1424.50 |
| |
|
|
|
| 2005 |
0203 |
Level IV Nerve Injections |
$600.85 |
For further information about the role of APC designations in coding, see Hospital Coding and Payment.
For further help with insurance and reimbursement, use our Reimbursement Calculation Tools.