Reimbursement

2019 Reimbursement Coding Information

 

Hospital Coding Guide

FibroScan® devices are FDA cleared as an aid to diagnosis and monitoring of adult patients with liver disease, as part of an overall assessment of the liver. FibroScan® devices utilize propiertary Vibration Controlled Transient Elastography (VCTE™), which utilizes a mechanically induced shear wave and does not utilize diagnostic imaging.

FibroScan® Testing is Covered Under Category I CPT Code 91200

Liver elastography, mechanically induced shear wave (e.g. vibration), without imaging, with interpretation and report: CPT Code 91200 for 2019

  • Hospital Outpatient Medicare Payment $135.95 (APC 5721)*

* CMS Hospital Outpatient Prospective Payment System 2019 Final Rule - CMS 1695-FC

 

Frequently Asked Questions

 

Q1.  Is there a CPT code for the FibroScan® examination?

Yes, testing billed under the new CPT category I code 91200 is specific to the FibroScan® examination.

Q2. How do hospital or outpatient facilities bill for a FibroScan® examination?

Hospital outpatient clinics performing the FibroScan® examination should bill 91200. Coverage and payment of FibroScan® examination may vary by commercial payers.

Q3. How do hospital physicians bill for reviewing and reporting the FibroScan® examination?

The physician charging for test interpretation and reporting will bill 91200-26 which is 0.40 RVU. Coverage and payment for FibroScan® examination may vary by commerical payers.

Q4. Who may I contact with my questions about FibroScan® examination reimbursement?

Echosens maintains a Reimbursement Hotline at (866) 905-4837, option number 4. 

 


 

Physician Office Coding Guide

FibroScan® Testing is Covered Under Category I CPT Code 91200

Liver elastography, mechanically induced shear wave (e.g. vibration), without imaging, with interpretation and report: CPT Code 91200 for 2019

  • Physician Office Medicare Payment $39.65 (1.14 RVU)

* CMS Physician  Fee Schedule CY2019 Final Rule 1693-F. Conversion Factor 36. 0391

 

Frequently Asked Questions

 

Q1. Is there a CPT code for the FibroScan® examination?

Yes, category 1 CPT code 91200 is specific to the FibroScan® examination.

Q2. How do physician offices bill for a FibroScan® examination?

Physician offices performing the FibroScan® examination should bill 91200. Coverage and payment of a FibroScan® examination may vary by commercial payers.

Q3. Who may I contact with my questions about FibroScan® examination reimbursement?

Echosens™ maintains a Reimbursement Hotline at 866-905-4837, option number 4.