Understanding TCAR Reimbursement
Silk Road Medical is pleased to provide the latest resources and information concerning coding, payment and coverage of TransCarotid Artery Revascularization (TCAR).
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The information provided herein is for informational purposes only and is intended to explain coverage, coding, and payment policies potentially applicable to TCAR using Silk Road Medical’s ENROUTE Transcarotid Neuroprotection (NPS) and Stent System.
TCAR may be described by the same Current Procedural Terminology (CPT®)1 codes and International Classification of Diseases, codes (10th revision, clinical modification) (ICD-10-CM) as Carotid Angioplasty and Stenting (CAS). Reimbursement policies and rates applicable to TCAR may be similar to those applicable to CAS.
The ENROUTE Transcarotid NPS and the ENROUTE Transcarotid Stent have been cleared and approved by the U.S. Food and Drug Administration (FDA) for use in the treatment of certain medical conditions. These conditions can be identified by specified ICD-102 diagnosis and procedure codes. The ICD-10 Clinical Modification (ICD-10-CM) codes crosswalk to Medicare Severity Diagnosis Related Groups (MS‐DRG) for the purposes of hospital inpatient reimbursement. Medicare and most other insurers typically make payment for services based on fee schedules tied to CPT codes or MS-DRGs.
TCAR Reimbursement Questions:
Please contact your Silk Road Medical representative or call 1-855.410.TCAR (8227)
1 CPT copyright 2015 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
2 10th revision of the International Statistical Classification of Diseases and Related Health Problems
Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. Please refer to package inserts for indications, contraindications, warnings, precautions, and instructions for use.
Silk Road Medical provides this content for informational purposes only. The information contained herein is gathered from various sources and is subject to change without notice. Silk Road Medical cannot guarantee success in obtaining coverage or payment. Reimbursement for medical products and services is affected by numerous factors. It is always the provider’s responsibility to determine and submit appropriate codes, charges, and modifiers for services that are rendered. Actual codes and/or modifiers used are at the sole discretion of the treating physician and/or facility. Providers should contact their third-party payers for specific information on their coding, coverage, and payment policies. This guide is in no way intended to promote the off‐label use of any medical device. Information last reviewed February 17, 2017.