WASHINGTON—The Centers for Medicare & Medicaid Services have not enacted coding edits that would have changed how certain vascular access procedures are billed.
“This edit will allow physicians to continue aggressive salvage and maturation procedures for fistulas, which are critical to the long-term health of our dialysis patients,” said Gerald A. Beathard, MD, PhD, Lifeline Vascular Access vice president of provider development.
In January, the National Correct Coding Initiative, a Medicare program contracted to outside companies, proposed an edit that would have bundled the codes G0392 and G0393, created a new definition of an arterial versus venous angioplasty, and would have ended the use of the code 35476 for draining a forearm fistula.
The changes would have been enacted April 1. However, a coalition of renal association and industry formed to fight the proposed edit changes. According to DaVita, a subset of the coalition met with CMS to “discuss the complexities of access care, especially in a fistula first environment.”
The subset that spoke with CMS included representatives from the American Society of Diagnostic and Interventional Nephrology, the American Association of Kidney Patients, the Arizona Kidney Disease and HypertensionCenter, DaVita, Kidney Care Partners, Lifeline Vascular Access and the Renal Physicians Association.
“We are happy to say that the April edits have been released from NCCI and none of the threatened edit changes have been issued,” ASDIN wrote on its Web site. ASDIN cautioned members that CMS can change the coding at any time. In addition, the association said their argument “has been constructed on the premise that fistulas are much more difficult to deal with than grafts. It is of paramount importance that we as a community generate a body of evidence to support this contention scientifically.”
