Covidien’s Healthcare Economics and Reimbursement Department has worked diligently to ensure positive coverage policies with Medicare and national insurance plans, which include Aetna, Cigna, Humana, Health Net and United Healthcare. We also provide coverage with regional plans, such as Blue Cross Blue Shield.
As with most venous procedures, medical necessity must be established in order for the patient to be covered under their insurance plan. Each insurance coverage policy lists requirements for the procedure to be considered medically necessary. These policies vary by insurer and by plan, so physicians are advised to review the top medical policies in their service area to familiarize themselves with the specific criteria.
Covidien provides information on coding for Venefit™ Targeted Endovenous Therapy. However, coding information is complex, changes over time and is subject to individual interpretation by payers. As a result, physicians are strongly advised to consult with their own counsel regarding coding and payment. The final decision for billing any service must be made by the physician’s office, hospital or ambulatory surgery center billing staff. They must consider the medical necessity of the service furnished, as well as the requirements of payers and any local, state or federal laws and regulations that apply. Covidien provides this information in an educational capacity only, with the understanding that Covidien is not engaged in rendering coding, financial or other professional consulting services.
Covidien is committed to assisting physicians and facilities through the reimbursement process. The Reimbursement Department offers weekly webinars to educate new and existing practitioners on the basics of coding for the Venefit™ procedure. In addition, Covidien Territory Sales Managers (TSMs) are trained to answer your routine coding questions and provide useful tools to assist with your coding needs.