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
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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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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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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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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Stenting Coding & Payment Reference 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
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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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, 2008 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 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, 2008 Drug-eluting Stents
This guide provides reimbursement information on drug-eluting stent procedures.
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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, 2008 IVUS Coronary
This guide provides reimbursement information on coronary intravascular ultrasound(IVUS) 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, 2008 FilterWire
This guide provides reimbursement information on coronary intravascular procedures for FilterWire.
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Coding, Hospital Inpatient Bifurcation Procedure Codes
The following guide discusses new codes effective 10-1-06 for coronary and peripheral bifurcation procedures. Inpatient procedures will continue to code primary intervention procedures and the new code will track resource use.
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Coding, 2008 Carotid Artery Stenting Procedures
This guide reviews coverage criteria and possible coding options for carotid artery stenting procedures for both Medicare and non-Medicare patients.
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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, 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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CMS Payment, 2008 Physician and Hospital Payment for Carotid Artery Stenting (CAS)
The Centers for Medicare and Medicaid Services (CMS) provides physicians and facilities payment guidance for carotid artery stenting (CAS) procedures.
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Coverage, Indications for Medicare Coverage of Carotid Artery Stenting
This guide provides Centers for Medicare and Medicaid Services (CMS) coverage criteria for carotid stenting for Medicare beneficiaries.
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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, 2008 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.
Download Guide (PDF)
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.
Download Guide (PDF)
Coding, 2008 Carotid Artery Stenting Procedures
This guide reviews coverage criteria and possible coding options for carotid stenting procedures for both Medicare and non-Medicare patients.
Download PDF
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, 2008 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 Uterine Fibroid Embolization – Quick Reference Guide
This guide provides coding guidance and reimbursement information for uterine fibroid embolization procedures.
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Coding, 2008 Chemoembolization of Liver Tumors – Quick Reference Guide
This guide provides coding guidance and reimbursement information for chemoembolization of liver tumor 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, 2008 Peripheral Cutting Balloon
This guide provides information on billing for procedures using the Peripheral Cutting Balloon for office and hospital procedures.
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Coding, 2009 Peripheral Cutting Balloon
This guide provides information on billing for procedures using the Peripheral Cutting Balloon for office and hospital procedures.
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Coding, 2008 IVUS Peripheral
This guide provides reimbursement information on peripheral intravascular ultrasound(IVUS) procedures.
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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, 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.
Download Guide (PDF)
Coverage, Indications for Medicare Coverage of Carotid Artery Stenting
This guide provides Centers for Medicare and Medicaid Services (CMS) coverage criteria for carotid stenting for Medicare beneficiaries.
Download Guide (PDF)
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, 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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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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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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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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