Cardiac Rhythm Management
Boston Scientific's Cardiac Rhythm Management (CRM) Group is a leading developer of implantable devices used to treat cardiac arrhythmias, sudden cardiac arrest and heart failure. Boston Scientific’s
Electrophysiology Group is a leading developer of less-invasive medical technologies used in the diagnosis and treatment of rate and rhythm disorders of the heart.
As part of the CRM Group's commitment to advancing patient access to lifesaving technology, we work directly with the Centers for Medicare and Medicaid Services (CMS), public and private health insurers, and industry stakeholders to ensure appropriate reimbursement for services involving our products.
Learn more about reimbursement for CRM products and therapies, access C-code guides, and learn about our webcast programs. Click Here to view all CRM reimbursement content.
Gastroenterology
Stenting Coding & Payment Quick Reference Guide
This guide provides coding guidance and reimbursement information for stenting procedures.
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Endoscopy C-code Summary
This guide cross-references Boston Scientific devices to appropriate C-codes.
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Gastroenterology Reimbursement Codes & Payment - 2009
This document provides a summary of CPT codes and payments for all Gastroenterology products.
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Gastroenterology Glossary of Terms
A one page guide to commonly referred to reimbursement acronyms, terms and definitions.
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Biliary Coding & Payment Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for biliary procedures and reflects the 2008/09 Inpatient Hospital Rates.
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Biopsy Coding and Payment Quick Reference Guide-2009
This guide provides coding guidance and reimbursement information for biopsy procedures.
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Dilation Coding and Payment Quick Reference Guide-2009
This guide provides coding guidance and reimbursement information for dilation procedures.
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Enteral Feeding Coding and Payment Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for enteral feeding procedures.
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Cholangioscopy procedure with SpyGlass® System Description
The attached procedure description may be helpful in describing the cholangioscopy procedure with the SpyGlass System to payers.
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Hemostasis/Clipping Coding and Payment QRG - 2009
This guide provides coding guidance and reimbursement information for hemostasis and clipping procedures and reflects the 2008/09 Inpatient Hospital Rates.
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Polypectomy Coding and Payment Quick Reference Guide - 2009
This guide provides coding guidance and reimbursment information for polypectomy procedures.
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Pulmonary Coding & Payment Reference Guide - 2009
This guide provides coding guidance and reimbursement information for pulmonary procedures and reflects the 2008/09 Inpatient Hospital Rates, effective October 1, 2008.
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Radiofrequency Ablation Coding of Liver Tumors - Quick Reference Guide-2009
This guide provides coding guidance and reimbursement information for radiofrequency ablation coding of liver tumors.
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Spyglass® Coding & Payment Reference
This guide provides coding guidance and reimbursement information for Spyglass procedures and reflects the 2008/09 Inpatient Hospital Rates, effective October 1, 2008.
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Procedural Reimbursement Guide-2009
This guide provides coding guidance and reimbursement information for metal stent procedures and reflects the 2008/09 Inpatient Hospital Rates.
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Gastroenterology C-Code Cross Reference Guide-2009
This guide cross-references Boston Scientific gastroenterology products at the UPN/order number level to appropriate C-codes.
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Gynecology
Pinnacle Quick Reference Guide - 2009
This guide provides coding and reimbursement information for the Pinnacle Pelvic Floor Repair Kit
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Medicare Pass Through C-Code Questions and Answers
This document addresses questions pertaining to the 2008 Medicare update on Medicare pass-through C-codes.
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Office-Based Surgery Frequently Asked Questions
This document addresses frequently asked questions related to physician office-based surgery.
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Uphold™ Vaginal Support System Coding Reimbursement - 2009
This guide provides coding guidance and reimbursement information for the Uphold™ Vaginal Support System.
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Urethral Bulking with Coaptite® Injectable Implant Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for urethral bulking with Coaptite® as well as state specific reimbursement rates for L8606.
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Endometrial Ablation with HTA® System Quick Reference Guide with State Specific Rates - 2009
This guide provides coding guidance and reimbursement information for procedures using the HTA System.
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Mesh & Concomitant Repairs Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for pelvic floor reconstructive procedures and reflects the 2008/09 Inpatient Hospital Rates.
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Pelvic Floor Concomitant Repairs Billing Guide - 2009
This guide provides a summary of Correct Coding Initiative (CCI) Edits for Pelvic Floor Reconstructive Procedures.
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Sling Procedure Quick Reference Guide-2009
This guide provides coding guidance and reimbursement information for sling procedures and reflects the 2008/09 Inpatient Hospital Rates.
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Women's Health Reimbursement Codes and Payment - 2009
This document provides a summary of CPT codes and payments for all Women's Health Products
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Women's Health Cross Reference Guide
This guide cross-references Boston Scientific women's health products at the UPN/order number level to appropriate C-codes.
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Commonly Used DX Codes - PFR and UI - 2009
This guide provides information for commonly used ICD-9 Diagnoses Codes for Pelvic Organ Prolapse and Urinary Incontinence.
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Interventional Bronchoscopy
Endoscopy C-Code Cross Reference Guide
This guide provides a C-code cross reference list for Boston Scientific's Endoscopy products.
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Endoscopy Reimbursement Guide and CPT Codes
This document provides a general overview of medicare payment methods and reimbursement infomration for all Endoscopy CPT Codes.
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Pulmonary Coding and Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for pulmonary endoscopic procedures.
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Endoscopy Glossary of Terms
A one page guide to commonly referred to reimbursement acronyms, terms and definitions.
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Interventional Cardiology
Coding, 2009 Procedural Reimbursement Guide
This Procedural Reimbursement Guide for select Percutaneous Cardiovascular and other interventional procedures – Coronary and Peripheral - provides coding and reimbursement information for physicians and facilities.
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Coding, Interventional Cardiology C-code Cross-Reference Guide
This C-code cross reference guide crosswalks Boston Scientific interventional cardiology products by product numbers to Medicare hospital outpatient category codes (C-codes).
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Coding, 2009 Drug-eluting Stents
This guide provides reimbursement information on coding drug-eluting stent procedures
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Coding, 2009 IVUS Coronary
This guide provides reimbursement information on coronary intravascular ultrasound (IVUS) procedures.
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Coding, 2009 Carotid Artery Stenting (CAS) Quick Reference
This guide provides coverage, coding and reimbursement information for carotid artery stenting procedures that utilize Boston Scientific products.
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CMS Payment, 2009 Medicare Final HOPPS, ASC and Physician Payment Rates
Medicare final rules (FR) highlights for two documents published October 30, 2008. The first FR addresses the payment and policies for hospital outpatient and Ambulatory Surgical Centers (ASC). The second Final Rule addresses physician payment and policy. All three sets of payment rates effective January 1, 2009.
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CMS Payment, 2010 Medicare Proposed Hospital Inpatient MS-DRG Rates - NEW
Medicare FY2010 Inpatient Proposed Rule highlights including National Average Payment for select Interventional Cardiology and Peripheral Interventions MS-DRGs. Overall rates are relatively stable with no major changes to the MS-DRG inpatient prospective payment system. CMS’ final IPPS rule will be published around August 1 and will go into effect on October 1, 2009.
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CMS Payment, 2009 Medicare Final Hospital Inpatient MS-DRG Rates
Medicare FY2009 Inpatient Final Rule highlights including National Average Payment for select Interventional Cardiology and Peripheral Interventions MS-DRGs. Overall rates are relatively stable with no major changes to the MS-DRG inpatient prospective payment system. Final rates and policy changes issued July 31 become effective October 1, 2008.
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Coverage, Initial App and Recertification for Eligibility for Medicare Reimbursement for CAS
This document reviews the processes and data submission requirements and timelines for seeking Medicare certification and recertification as a CAS facility. Also includes list of eligible facilities
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Coverage, Template Initial Certification Letter for Facilities with Prior Clinical Trial Experience
If your facility has CAS clinical trial experience and you would like to request inclusion on the list of facilities eligible for Medicare reimbursements for CAS procedures, please refer to this template for sample guidelines.
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Coverage, Template Initial Certification Letter for Facilities with No Clinical Trial Experience
If your facility does not have CAS clinical trial experience, but meets the minimum standards for facilities eligible for reimbursement for CAS procedures, as outlined in the CMS National Coverage Determination (NCD) for Percutaneous Transluminal Angioplasty (PTS) and CAS, and you would like to request inclusion on the list of Medicare-approved, please refer to this template for sample guidelines.
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Coverage, Template Letter for Prior Approval/Medical Necessity
The following is a sample letter template that can be used for guidance by physicians when submitting claims to Medicare and when seeking prior authorization or submitting claims to non-Medicare payers
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Interventional Radiology
Coding, 2009 Procedural Reimbursement Guide
This Procedural Reimbursement Guide for select Percutaneous Cardiovascular and other interventional procedures – Coronary and Peripheral - provides coding and reimbursement information for physicians and facilities.
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Coding, 2009 Carotid Artery Stenting (CAS) Quick Reference
This guide provides coverage, coding and reimbursement information for carotid artery stenting procedures that utilize Boston Scientific products.
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Coding, 2009 Express® SD Renal Monorail® Premounted Stent System
This guide provides reimbursement information for procedures utilizing the Express® SD Renal Monorail® Premounted Stent System and other Boston Scientific products indicated for use in those procedures.
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Coding, 2009 PolarCath® Peripheral Dilatation System
This guide provides reimbursement information for peripheral vascular procedures utilizing the PolarCath®
Peripheral Dilatation System.
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Coding, 2009 Uterine Fibroid Embolization – Quick Reference Guide
This guide provides coding guidance and reimbursement information for uterine fibroid embolization procedures.
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Coding, 2009 Chemoembolization of Liver Tumors – Quick Reference Guide
This guide provides coding guidance and reimbursement information for chemoembolization of liver tumor procedures that utilize Boston Scientific products.
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Coding, 2009 IVUS Peripheral
This guide provides reimbursement information for peripheral intravascular ultrasound (IVUS) procedures.
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2009 Radiofrequency Ablation Coding of Liver Tumors - Quick Reference Guide
This guide provides coding guidance and reimbursement information for radiofrequency ablation coding of liver tumors.
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CMS Payment, 2009 Medicare Final HOPPS, ASC and Physician Payment Rates
Medicare final rules (FR) highlights for two documents published October 30, 2008. The first FR addresses the payment and policies for hospital outpatient and Ambulatory Surgical Centers (ASC). The second Final Rule addresses physician payment and policy. All three sets of payment rates effective January 1, 2009.
Download Guide (PDF)
CMS Payment, 2010 Medicare Proposed Hospital Inptatient MS-DRG Rates - NEW
Medicare FY2010 Inpatient Proposed Rule highlights including National Average Payment for select Interventional Cardiology and Peripheral Interventions MS-DRGs. Overall rates are relatively stable with no major changes to the MS-DRG inpatient prospective payment system. CMS’ final IPPS rule will be published around August 1 and will go into effect on October 1, 2009.
Download Guide (PDF)
CMS Payment, 2009 Medicare Final Hospital Inpatient MS-DRG Rates
Medicare FY2009 Inpatient Final Rule highlights including National Average Payment for select Interventional Cardiology and Peripheral Interventions MS-DRGs. Overall rates are relatively stable with no major changes to the MS-DRG inpatient prospective payment system. Final rates and policy changes issued July 31 become effective October 1, 2008.
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Coverage, Initial App and Recertification for Eligibility for Medicare Reimbursement for CAS
This document reviews the processes and data submission requirements and timelines for seeking Medicare certification and recertification as a CAS facility. Also includes list of eligible facilities
Download Guide (PDF)
Coverage, Template Initial Certification Letter for Facilities with Prior Clinical Trial Experience
If your facility has CAS clinical trial experience and you would like to request inclusion on the list of facilities eligible for Medicare reimbursements for CAS procedures, please refer to this template for sample guidelines.
Download Guide (MS Word)
Coverage, Template Initial Certification Letter for Facilities with No Clinical Trial Experience
If your facility does not have CAS clinical trial experience, but meets the minimum standards for facilities eligible for reimbursement for CAS procedures, as outlined in the CMS National Coverage Determination (NCD) for Percutaneous Transluminal Angioplasty (PTS) and CAS, and you would like to request inclusion on the list of Medicare-approved, please refer to this template for sample guidelines.
Download Guide (MS Word)
Coverage, Medicare Data Submission Template
This submission template is intended as a guidance document only and must be tailored to address and include the specifics of your institution. It has been drafted in a form responsive to the requirements set forth in the Medicare National Coverage Determination for Carotid Artery Stenting and the Carotid Artery Stenting Facility Recertification Process described in the CMS webstie, both of which remain subject to change at any time and without notice.
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Coverage, Template Letter for Prior Approval/Medical Necessity
The following is a sample letter template that can be used for guidance by physicians when submitting claims to Medicare and when seeking prior authorization or submitting claims to non-Medicare payers
Download Guide (MS Word)
Neurovascular Intervention
Neuroform® Microdelivery Stent System Hospital Coding Guide - 2008
This quick reference provides coding and Medicare reimbursement information for treatment of aneurysms that involve insertion of the Neuroform Microdelivery Stent System, a Humanitarian Use Device (HUD),1 in addition to embolization with detachable coils (such as GDC® or Matrix® Coils).
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SNIS Physician Coding & Payment Guide to Endovascular Treatment of Brain Aneurysms - 2008
The following guide provides coding and payment information for neuroendovascular repair of aneurysms for physician services. For additional details about hospital billing for these services, please consult the Society of NeuroInterventional Surgery (SNIS)1 Hospital Inpatient Guide.
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SNIS Hospital Coding Guide to Endovascular Treatment of Brain Aneurysms - 2008
The following guide provides coding and payment information for neuroendovascular repair of aneurysms for hospital inpatient services. For questions about physician billing, please consult the Society of NeuroInterventional Surgery (SNIS)1 Physician Guide.
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2007 Wingspan® Stent System with Gateway™ PTA balloon Catheter Coding Guide
This guide provides coding and reimbursement information for intracranial angioplasty and stenting procedures for intracranial atherosclerotic disease.
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Pain Management
Precision™ Spinal Cord Stimulation (SCS) System.
Boston Scientific is committed to providing our customers Coverage, Coding & Payment and Product information.
Our reimbursement professionals support Physicians, Hospitals, and Ambulatory Surgery Centers by:
- Educating providers on coding, billing, payer contracting
and reimbursement
- Improving payer coverage & receiving appropriate
payment levels
- Educating and assisting customers with the prior
authorization and appeal process
Use the link below to access up-to-date Educational, coverage, Coding & Payment and Product information.
Click here
Urology
Urology C-Code Cross Reference Guide
This guide cross-references Boston Scientific urology products at the UPN/order number level to appropriate C-codes.
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Bladder Tumor Procedures Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for bladder tumor procedures.
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BPH Laser Surgery Procedures with State Specific Rates Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for BPH Laser Surgery procedures.
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ESWL with Ureteral Stent Placement Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for ESWL with stent placement/removal procedures
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Litholapaxy Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for litholapaxy procedures.
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Medicare Pass-Through Codes (C Codes) Questions and Answers
This guide provides answers regarding the reinstatement of Medicare Pass-Through C Codes
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Office-Based Surgery' Frequently Asked Questions
This document addresses frequently asked questions related to physician office-based surgery.
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PCNL Quick Reference Guide- 2009
This guide provides coding guidance and reimbursement information for Percutaneous Nephrolithotomy (PCNL) procedures.
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Prolieve Thermodilatation® System Reimbursement Guide with State Specific Rates - 2009
This guide provides coding guidance and reimbursement information for procedures using The Prolieve Thermodilatation System.
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Radical Prostatectomy Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for radical prostatectomy procedures.
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Ureteroscopic Stone Removal with Lithotripsy Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for URS with lithotripsy procedures.
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Ureteroscopic Stone Removal without Lithotripsy (with stent placement) Quick Reference Guide - 2009
This guide provides coding guidance and reimbursement information for URS without lithotripsy procedures.
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Urology Reimbursement Codes and Payment - 2009
This document provides a summary of CPT codes and payments for all Urology products.
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