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IDET™

INTRADISCAL ELECTROTHERMAL™ Therapy

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APC Changes

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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.

  • Hospital Coding and Payment
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