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12/16/2024

Surgical Tray Reimbursement

Can we bill A4550 for a surgical tray and get reimbursed for it in western New York?

HCPCS A4550 - Surgical trays

This answer differs based on the third party payer the claim is being submitted to.  Different payers have different payment policies and there are dozens of third party payers in New York.  The only way to know if a third party payer provides reimbursement for this code is to check with that third party payer.  There is not one answer that applies to all payers.

One example is Medicare, which does not provide reimbursement for HCPCS A4550.  

Chapter 12, Section 20.4.4 - "Supplies" (Rev. 1, 10-01-03) B3-15900.2 of the Medicare Claims Processing Manual (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104C12.pdf) states that there is no separate payment made for A4550.

 

Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA  

Certified Professional Coder

Certified Professional Medical Auditor                                           

Lehrman Consulting, LLC

 

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