REIMBURSEMENT PTNM FOR SENIOR LIVING RESIDENTS

Reimbursement Tools

To ensure that a patient meets the medically necessary policy criteria, or to find out if coverage prior authorization/pre-determination is required, please contact the patient’s payer directly. Medtronic provides this information for your convenience only. It is the responsibility of the provider to determine coverage and submit appropriate codes, modifiers, and charges for the services rendered. The information below provides assistance for FDA approved or cleared indications.

pdf PTNM for Urinary Control Reimbursement Guide — Senior Living Facilities (.pdf)

ICD-10-CM Diagnosis and Procedure Codes, CPT® Procedure Codes, Coding FAQs, Letter of Medical Necessity

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Where reimbursement is requested for a use of a product that may be inconsistent, or not expressly specified in the FDA cleared or approved labeling (e.g., instructions for use, operator’s manual, or package insert), consult with your billing advisors or payers for advice on handling such billing issues. Some payers may have policies that make it inappropriate to submit claims for such items or related service. Contact your Medicare contractor or other payer for interpretation of coverage, coding, and payment policies.